1. Introduction
Mastitis, an inflammation of the mammary gland caused by an infection, trauma, or injury to the udder, is one of the most common diseases of dairy animals that affects the wellbeing of livestock populations in this study area [
1,
2,
3,
4,
5,
6,
7]. Mastitis causes substantial economic losses due to reduced milk yield, treatment costs, discarding of milk with antibiotics, the lower price of poor-quality milk, and death from severe inflammation [
8,
9]. In Ethiopia, mastitis causes major economic losses, mainly due to milk production losses and culling [
10,
11,
12]. About 137 infectious agents are known to cause mastitis in large domestic animals, of which bacteria are the major ones [
13]. The most common bacteria that cause mastitis are
Staphylococcus,
Streptococcus, and coliform bacteria (
E. coli,
Klebsiella spp., and
Enterobacter spp.) [
14].
Staphylococcus aureus is one of the leading causes of mastitis in dairy cattle in Ethiopia [
3,
15,
16,
17], resulting in significant economic losses due to direct and indirect costs [
10]. Similarly,
Streptococcus spp. and coliform bacteria are frequently reported to cause mastitis in Ethiopia [
3,
5,
17,
18].
Staphylococcus aureus is a contagious mastitis pathogen.
Staphylococcus aureus is a Gram-positive, catalase and coagulase-positive, non-spore-forming, oxidase negative, non-motile, cluster-forming, facultative anaerobe [
19].
Staphylococcus aureus is usually isolated from different body parts of dairy animals, including the head, skin, leg, and nasal mucosa as well as the milker’s hands. However, an infected udder quarter remains the main reservoir of infection for non-infected animals during the milking time through contaminated milkers’ hands, towels, and milking machines [
20].
Staphylococcus aureus can be distinguished from other staphylococcal species on the basis of the production of coagulase, the fermentation of mannitol, and trehalose [
21]. The coagulase test is not an absolute test for confirming the diagnosis of
S. aureus in cases of bovine mastitis; however, more than 95% of all coagulase-positive staphylococci from bovine mastitis belong to
S. aureus [
22].
Coliform bacteria include the genera
Escherichia, Klebsiella, and
Enterobacter [
23]. Coliform bacteria are a major cause of clinical mastitis [
24]. The most common species, isolated in more than 80% of cases of coliform mastitis, is
Escherichia coli [
25,
26].
E. coli usually infects the mammary glands during the dry period and progresses to inflammation and clinical mastitis during early lactation, with local and sometimes severe systemic clinical manifestations. If the infection is localized in the mammary gland and there is no systemic involvement, treatment with an antibiotic is not recommended, since it worsens the inflammatory response due to bacterial death and the release of LPS, which might lead to poor prognosis and worse animal welfare. Clinical mastitis may display severe systemic clinical manifestations. For example, there are reports that found 32% of coliform mastitis cases showed bacteremia (the presence of bacteria in the circulating blood) [
27,
28]. Approximately 10% of clinical mastitis may lead to death [
29].
In general, previously published data did not demonstrate widespread antimicrobial resistance (AMR) among mastitis pathogens [
30,
31]. However, recent studies have shown increased resistance against tetracycline among
S. aureus [
32] and
E. coli isolates [
33] from cases of mastitis. There is no doubt that antimicrobial usage in food animal production leads to an increase in AMR [
34,
35]. Dairy farms may serve as a source of antimicrobial-resistant human pathogenic bacteria, especially extended spectrum beta-lactamases producing
E. coli [
33,
36] and colistin-resistant
E. coli [
37]. Extensive use of third-generation cephalosporins (3GCs) in dairy cattle for the prevention and treatment of mastitis [
31,
38,
39] and other diseases of dairy cattle [
40,
41] could result in the carriage of extended-spectrum beta-lactamase-producing
Enterobacteriaceae (ESBL Ent) [
33,
42,
43].
The somatic cell counts (SCCs) of milk from dairy cattle, camels, and goats are different but the California Mastitis Test (CMT) has been used frequently to estimate increased somatic cell counts in these species. SCC has been determined in camel milk to diagnose clinical or subclinical mastitis [
44,
45,
46]. The SCC values in the bulk milk of clinically healthy dromedaries are higher than those from dairy cows but lower than those in sheep and goats [
47]. Similarly, SCC is used to determine subclinical mastitis in goats [
48]. Generally, healthy goats have a higher milk SCC compared with sheep and other ruminants such as cows. Some have reported a SCC of ≥ 10
6 cells/mL as an indication of subclinical mastitis in goats; however, this set minimum is usually combined with a bacteriological test to confirm diagnosis. The SCC with a bacteriological test is the most reliable indicator of subclinical mastitis in goats [
49]. In addition, the SCC in goat milk varies based on the stage of lactation, and it has been reported to reach 3.6 × 10
6 cells/mL at the end of lactation [
50].
The interaction between milk quality parameters and various factors influencing milk quality has been studied extensively in conventional dairy species. In cow and sheep milk, low bulk tank bacterial count is associated with low SCC and the increase in one parameter coincides with the increase of the other [
51,
52,
53]. Milk quality parameters are influenced by many factors, including year, season, month, herd, age, parity, breed, stage of lactation, intramammary infection, environmental factors, and management practices [
54,
55,
56,
57,
58,
59,
60]. The complex interactions among the abovementioned factors determine the final quality of the bulk tank milk. In the United States, the pyronin Y-methyl green (PMG) staining procedure is considered the standard confirmatory test and is the official reference method for direct microscopic somatic cell count (DMSCC) in goat milk [
54]. A similar method has been adopted for SCC in camel milk in other areas [
47].
This study area is close to the border between Ethiopia and Kenya, and indiscriminate use of antimicrobial drugs from different sources to treat animal and human diseases is very common. Raw milk consumption is a widely practiced culture in this area, which predisposes the consumers to milk-borne infections. The objectives of this study were (1) to determine the prevalence of mastitis in dairy cattle, goats, and camels in this study area and (2) to isolate and identify the etiological agents from cases of mastitis and determine the antibiotic resistance patterns of bacterial isolates against commonly used antibiotics in the area.
4. Discussion
Our mastitis prevalence results in dairy cattle were closely similar to those of Haftu et al. [
65], who reported a cow-level prevalence of 37.4%, consisting of 3.6% clinical and 33.8% subclinical cases, with a quarter-level prevalence of 17.8% in Northern Ethiopia. Our results were higher than that of Abera et al. [
2], who reported a prevalence of 30.3% and 10.3% at the cow and quarter levels, respectively, in small dairy farms in and around Hawassa in Southern Ethiopia. We found a lower prevalence than Lakew et al. [
5], Birhanu et al. [
66], Abebe et al. [
67], Mekonnen et al. [
16], Sarba et al. [
68], Zeryehun et al. [
69], Tolosa et al. [
70], Lakew et al. [
71], Abdella et al. [
17], and Kerro Dego et al. [
3] in different parts of Ethiopia. Similarly, Getaneh et al. [
4] conducted a meta-analysis of 39 published articles from 2002 to 2016; they found a higher pooled prevalence of 47% at cow level, of which 8.3% and 37% were clinical and subclinical mastitis, respectively. Getahun et al. [
18] also reported a high prevalence of 54.7%, 22.3%, and 10.1% of subclinical mastitis and a low prevalence of 8.3%, 1.8%, and 0.51% of clinical mastitis at the herd, cow, and quarter levels, respectively, in crossbreed lactating cows from smallholder dairy farms in the Sellalle area of Central Ethiopia. These variations are mainly because of differences in the production system (intensive, semi-intensive, and extensive), ecology, management, and methodological differences among these studies.
Our mastitis prevalence results in camels were closely similar to those of Abera et al. [
72], who reported an overall prevalence of 29% and 17.9% at the animal and quarter levels, respectively, in lactating camels in the Jijiga area of Somali Regional State in Eastern Ethiopia. Our results were lower than those of Regassa et al. [
73], who reported a prevalence of 44.8% in camels in the neighboring Borena Zone, of which clinical and subclinical mastitis made up 5.4% and 39.4%, respectively. We found a quarter-level prevalence of 14.6% in camels, which was lower than 24% reported by Regassa et al. [
73] in camels in the Borena Zone. These variations may be due to a slight difference in the ecological area and management differences. Similarly, Bekele et al. [
7] reported a higher clinical mastitis prevalence of 12.5% in camels from the Afar Region, and Abdel Gadir Afit et al. [
1] also reported an intramammary infection (IMI) rate of 59.7%, of which 75% and 25% had major and minor mastitis pathogens, respectively, in camels in the Negele Borena, Dire Dawa, and Gewane areas of Ethiopia. Despite the similarity in the pastoral production systems in these areas, there are several differences in management and mastitis control practices among camel herders in these areas, which might contribute to differences in disease prevalence in these areas.
Our mastitis prevalence results in goats were higher than those of Megersa et al. [
6], who reported an overall prevalence of 15.5%, of which clinical and subclinical cases made up 4.3% and 11.2%, respectively, in lactating dairy goats under the same pastoral management system in the neighboring Borena Zone. Despite the similarity of the pastoral production systems, flock management still varies greatly, which might contribute to the observed difference in the prevalence of mastitis. For example, Borana’s pastoral community is in the lowlands, where drought and feed and water shortages are major problems, whereas Guji’s pastoral community in the Bule Hora district is in the mid-highlands, where drought is not a significant problem. Similarly, Dugda Dawa is located in the lowlands but has no water shortage because of proximity to good water sources. Not all pastoralists manage their animals in the same manner: some are good at vaccinating all their animals, whereas some do not vaccinate all animals, which might influence the overall health of each animal.
Mastitis is a complex multifactorial disease involving interactions of various factors such as the type of management and husbandry, environmental conditions, animal risk factors, and causative agent-related factors, so variations in prevalence could be due to variations of these different factors.
We found 3.3%, 2.5%, and 1.7% blind quarters/halves in cows, camels, and goats, respectively. Lakew et al. [
5] reported the same result of 3.3% blind quarters in cows from Haramaya. Our result was lower than that of Sarba et al. [
68], Zeryehun et al. [
69], and Tolosa et al. [
74], who reported blind quarters in 5.5%, 6.6%, and 6% of cows in the Ambo district of the East Shewa Zone, Eastern Hararge Zone, and Jimma, respectively. We found a lower number of blind quarters (2.5%) in camels compared with Abera et al. [
72], who reported 33.8% blind quarters in camels from the Jijiga area of Somali Regional State. This variation may be due to differences in treatment against mastitis in camels and health care for animals.
There were no significant differences in the prevalence of mastitis among different ages, parity number, and stages of lactation in camels, cows, and goats. However, the prevalence of mastitis tended to increase (
p = 0.028) with parity in camels. Abera et al. [
72] also reported that the prevalence of mastitis in camels was significantly affected by tick infestation, udder lesions, increased age, and parity of animals. Our results disagree with a previous study by Regassa et al. [
73] in camels, who reported a significantly higher prevalence in early lactation than in late lactation in the Borana Zone. In cows, the prevalence of mastitis was significantly (
p = 0.034) higher in the Dugda Dawa district compared with the Bule Hora district. Our results agree with that of Abera et al. [
2] in cows in Hawassa, who reported no association of the prevalence of mastitis with age, parity, and history of mastitis. On the contrary, others reported a higher prevalence of mastitis in older cows [
4,
5,
65,
66,
68], in crossbreeds than in indigenous zebu [
3,
5,
67,
68,
75], in cows at the late lactation stage [
2,
4,
16,
18,
65,
67,
74,
75], in cows at the early stage of lactation [
3,
4], in cows with a high parity number [
5,
16,
66,
67,
68,
75], and in cows with teat lesions and/or tick infestations [
3,
74]. In goats, the prevalence of udder and milk abnormalities, overall mastitis prevalence, and clinical and subclinical mastitis were not affected by the stage of lactation, district, and parity. Our results disagree with that of Megersa et al. [
6], who reported that does in the late lactation stage, those with long teats, those with poor body condition, and those examined in the wet season were at high risk of udder infection than those in early lactation, those with short teats, those with good body condition, and those examined in the dry period, respectively. However, significant variations were not observed for udder tick infestation, mixing goats with sheep, and flock size.
These variations might be due to several factors, including study methodology, differences in the number of animals included in the study, managemental differences, ecological differences, and differences in mastitis treatment and control practices among producers and herders.
The most prevalent isolates were coagulase-negative
Staphylococcus spp. (CNS) (
n = 25, 39.1%),
Staphylococcus aureus (
n = 11, 17.2%),
Staphylococcus hyicus (
n = 9, 14.1%), and
Staphylococcus intermedius and
Escherichia coli (both
n = 6, 9.4%). Our results were comparable with the previous report by Regassa et al. [
73], who reported the highest prevalence of
S. aureus at the animal and quarter levels of 12.8% and 2.9%, respectively, in camels in the Borana Zone. Similarly, Mekonnen et al. [
16] also reported that the predominant isolates were coagulase-negative
Staphylococcus spp. (31%), followed by
Staphylococcus aureus (9%) in cattle. Haftu et al. [
65] also reported
S. aureus (36%) and
E. coli (27.3%) as the major isolates from cases of mastitis in dairy cattle. Abebe et al. [
67] reported that
S. aureus was isolated from 51.2% of milk samples cultured and 73.2% of the herd affected with mastitis. Tolosa et al. [
74] reported that non-
aureus staphylococci were the most frequently isolated pathogens in both clinical mastitis cases and IMI. Different bacterial etiological agents were reported by different authors, including Bekele et al. [
7], Abera et al. [
2], Abdella et al. [
17], Almaw et al. [
75], Birhanu et al. [
66], Getahun et al. [
18], and Lakew et al. [
71], which mainly included
S. aureus, coagulase-negative staphylococci,
Streptococcus agalactiae,
Streptococcus dysgalactiae,
Streptococcus uberis, other
Streptococcus spp.,
Bacillus spp,
Pasteurella hemolytica, and
E. coli [
7].
The high prevalence of S. aureus in this study might be associated with the absence of hygienic milking practices, a lack of culling of cows chronically infected with S. aureus, and consistent hand-milking practices throughout the dairy herds. Since S. aureus is usually found on the udder or teat skin surface of infected animals, the primary source of transmission from infected udders to uninfected is usually by the milkers’ hands during hand-milking.
S. aureus isolates in this study showed high sensitivity to vancomycin, doxycycline, and ceftriaxone. This might be due to limited usage of these antimicrobials for the treatment of diseases of these species of dairy animals, including mastitis. This study showed that all
S. aureus isolates from cows, camels, and goats were resistant to penicillin G (100%) and spectinomycin (100%). Overall, we found that all
S. aureus isolates were multidrug-resistant, which agrees with the study of Haftu et al. [
65], who reported that all
S. aureus isolates from cows were multidrug-resistant, that were resistant to ampicillin, erythromycin, clindamycin, and chloramphenicol. This resistance might be due to repeated therapeutic and/or indiscriminate use of these antimicrobials in these study areas.
S. aureus isolates from cows were resistant to penicillin G (100%), spectinomycin (100%), clindamycin (83.33%), and vancomycin (83.33%). These results were in agreement with reports from [
76] in and around Assosa that suggested a possible development of resistance from prolonged and indiscriminate use of these antimicrobial drugs.
S. aureus isolates from camels were sensitive to polymyxin B (100%), vancomycin (75%), doxycycline (75%), and nitrofurantoin (75%), in agreement with the report of Teshome et al., [
77], which showed sensitivity to vancomycin (100%), doxycycline (100%), and norfloxacin (100%) in the Somali Region of Ethiopia. According to [
77], there is high resistance to polymyxin B (75%) in the Somali Region, which is mainly due to prolonged and indiscriminate use of this drug in the area. However,
S. aureus isolates were sensitive to polymyxin B (100%), since this drug is not frequently used in veterinary services in the study districts.
S. aureus isolates from goats were resistant to penicillin G (100%), spectinomycin (100%), polymyxin B (66.67%), and chloramphenicol (66.67%) but sensitive to doxycycline (100%), ceftriaxone (100%), vancomycin (100%), and nitrofurantoin (66.67%). A high percentage of antimicrobial resistance was observed against spectinomycin, polymyxin B, and penicillin G. These findings were in line with the results of [
78], who reported 87.2% resistance to penicillin in Ethiopia.
In this study, S. intermedius isolates from cows were resistant to penicillin and polymyxin B but sensitive to chloramphenicol and nitrofurantoin. All S. intermedius isolates from camels and goats were 100% resistant to all antibiotics tested but 50% of isolates from camels were sensitive to ceftriaxone, chloramphenicol, doxycycline, and clindamycin, whereas 50% of isolates from goats were sensitive to chloramphenicol and doxycycline.
Contrary to our findings, Getahun et al. [
18] reported that all three
S. intermedius isolates from cows showed 100% susceptibility to ampicillin, penicillin, kanamycin, erythromycin, polymyxin B, streptomycin, and oxytetracycline and 75% sensitivity to sulfonamide. These authors [
18] also reported the lowest proportion of erythromycin- and sulfonamide-resistant
S. aureus isolates from dairy cows. All
S. hyicus isolates from cows were resistant to penicillin, spectinomycin, ceftriaxone, and doxycycline. All
S. hyicus isolates from cows were sensitive to polymyxin B, clindamycin, and nitrofurantoin. However, 66% and 33% of
S. hyicus isolates from cows were sensitive to vancomycin and chloramphenicol, respectively.
S. hyicus isolates from camels were resistant to penicillin, spectinomycin, ceftriazone, clindamycin, and polymyxin B and sensitive to nitrofurantoin and chloramphenicol. Fifty percent of
S. hyicus isolates from camels were resistant to vancomycin and doxycycline.
S. hyicus isolates from goats were resistant to penicillin, spectinomycin, and ceftriazone but showed reduced sensitivity to polymyxin B (75% sensitivity), doxycycline (75% sensitivity), and clindamycin (50% sensitivity).
Resistance to three or more antibiotic classes is multidrug resistance per the European Centre for Disease Prevention and Control (ECDC), which was found in 100% of
S. aureus isolates from cows, camels, and goats. This result was partially in agreement with the finding Malinowski et al. [
79], who reported multidrug resistance in
S. aureus species. This indicated an alarming rise in multidrug-resistant
S. aureus strains in cows, camels, and goats that presents a significant public health risk due to regular consumption of raw milk in this area.
All E. coli isolates from cows showed reduced sensitivity (50% sensitivity) to polymyxin B and nitrofurantoin, but each was resistant to all other antibiotics tested in this study. E. coli isolates from goats had reduced sensitivity (50% sensitivity) to spectinomycin, vancomycin, ceftriazone and doxycycline, each and clindamycin (25% sensitivity) but were sensitive (100% sensitivity) to polymyxin B, nitrofurantoin, and chloramphenicol. Gram-negatives have an intrinsic resistance to penicillin and so E. coli is not sensitive to penicillin.