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1.
Microbiologic culture revealed the following cause of mastitis and anorexia in 145 cows in Wisconsin to be Escherichia coli, 66 cows; Klebsiella spp, 3; Corynebacterium pyogenes, 27; streptococci, 21; staphylococci, 20; yeasts, 1; and no bacterial growth, 7. Mastitis was detected with approximately equal frequency throughout the year. Escherichia coli was isolated throughout the year, but was more common and was the predominant organism during the summer. Corynebacterium pyogenes was isolated most often in winter and spring; streptococci in fall, winter, and spring; and staphylococci throughout the year. Corynebacterium pyogenes caused most of the mastitis in nonlactating cows. Escherichia coli, C pyogenes, streptococci, and staphylococci were isolated with about equal frequency at parturition, whereas E coli was the predominant cause of mastitis in early and late lactation. Of cases of mastitis, 27% were seen 10 days before and after parturition. Local and systemic clinical signs of infection were similar for all causes, except that C pyogenes caused more (P less than 0.01) malodorous and purulent milk than did other organisms and was isolated more commonly from quarters with injured teats. Recovery was significantly (P less than 0.01) higher in cows with E coli infections, compared with recovery in cows with gram-positive organism infections. Cows with C pyogenes infections frequently had quarters that ultimately ceased lactation. A few cows were recumbent at initiation of antimicrobial therapy and a few were not eating 24 hours later; however, 50% of these cows recovered. Criteria such as season of year, stage of lactation, appearance of milk and udder, and appetite permitted the cause (gram-negative or gram-positive organisms) of the mastitis to be predicted with 77% accuracy.  相似文献   

2.
The clinical attributes of 40 dairy cows which had mastitis but no growth of bacteria from the milk were analyzed and compared to the attributes in 102 cows with only gram-positive and 61 cows with only gram-negative bacteria cultured from the milk. Cows with no bacteria cultured from the milk did not differ significantly from cows with gram-positive bacteria cultured, but 9 of 12 attributes were significantly different between cows with no bacteria cultured and cows with gram-negative bacteria cultured. Discriminant analysis was used to classify cows as members of the gram-positive or gram-negative culture groups. The discriminant equation was then applied to the cows with no bacteria cultured, and 78% of cows with no bacteria cultured were classified as members of the gram-positive group. Most mastitis in cows with no bacteria grown from the milk was probably due to gram-positive bacteria. If antibiotic therapy is used in cows with persistent mastitis and a negative culture in the belief that the culture is a false negative, treatment with antibiotics effective only against gram-negative organisms would not be appropriate.  相似文献   

3.
Medical records of 142 dairy cows with clinical mastitis were examined to determine whether hematologic or serum biochemical results could be used to distinguish between mastitis episodes caused by gram-negative bacteria (n = 78) from those caused by gram-positive bacteria (n = 64). Signalment, historic information, hematologic and serum biochemical results, milk culture results, and outcome (discharged from hospital or died) were obtained from the medical records. Cows with gram-negative mastitis had significantly (P < .01) lower blood leukocyte, segmented neutrophil, monocyte, and lymphocyte counts and had higher blood hemoglobin concentrations and hematocrits than did cows with gram-positive mastitis. Serum urea nitrogen was the only serum biochemical result associated with pathogen type, and it was higher in cows with gram-negative mastitis than in those with gram-positive mastitis. Mortality rate (25% overall) did not differ between groups. Logistic regression indicated that routine hematologic analysis (segmented neutrophil count, monocyte count, and hemoglobin concentration) was an accurate predictor of gram-negative mastitis, with a sensitivity of .93, a specificity of .89, and an overall accuracy of 91%. The values for sensitivity and specificity were higher than those previously reported for clinical tests differentiating mastitis episodes caused by gram-negative bacteria from those caused by gram-positive bacteria. Our results indicate that routine hematologic analysis is useful for predicting pathogen type in dairy cows with clinical mastitis, thereby facilitating treatment decisions.  相似文献   

4.
Recovery of cows (n = 61) with mastitis caused by gram-negative bacteria and treated systemically with an antibiotic (gentamicin) to which the bacteria were susceptible in vitro, was compared with recovery of cows (n = 13) with similar infections treated with a systemically administered antibiotic (erythromycin) to which the bacteria were resistant in vitro or with recovery of cows (n = 12) not given an antibiotic systemically. In the first part of the study, cows were selected for treatment groups by use of a diagnostic scheme designed to predict whether the mastitis was caused by gram-negative or gram-positive bacteria. In the second part of the study, all cows were treated without systemic administration of an antibiotic. Significant difference was not observed in the outcome of the disease between cows given gentamicin and cows of the other 2 treatment groups at 24 hours or at 4 weeks after treatment. At 24 hours after initial treatment, 71.9% of cows treated with gentamicin, 92.3% of those treated with erythromycin, and 45.5% not treated systemically had improved appetite. At 4 weeks after initial treatment, of the cows treated with gentamicin, 11.5% died; in 32.8%, lactation ceased in the affected mammary gland; in 21.3%, lactation was decreased in the affected gland; and 34.4% returned to normal lactation and health. Of cows treated with erythromycin, none died; in 23%, lactation ceased in the affected mammary gland; in 23%, lactation decreased in the affected gland; and 54% returned to normal lactation and health.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

5.
We used discriminant analysis to assess the indicants most useful in predicting whether a cow had coliform bacterial mastitis. One hundred and twenty-nine mastitic cows were divided into two groups, namely those with milk cultures that yielded pure or mixed gram negative organisms, and cows with other organisms or negative culture. Of 21 indicants examined by discriminate analysis only a history of previous mastitis in the affected quarter, weakness, clear or white color of milk, swelling of the udder, water consistency of the milk, lack of previous mastitis in other quarters, lack of palpable udder abscesses, and elevated body temperature were significantly associated with coliform mastitis. Using these variables 78% of cases were correctly classified.  相似文献   

6.
The objectives of this study were to determine 1) the effect of intramammary infection on calf weaning weight, milk somatic cell count, and milk composition, and 2) the effect of parity on percentages of infected cows, infected quarters, and blind quarters. The number of infected quarters, milk somatic cell counts, milk components, and intramammary infection were studied at weaning in 164 beef cows. The percentage of infected cows ranged from 61.9% at first parity to 66.7% at fifth to ninth parities. Cows with three or four infected quarters had higher (P < .01) milk somatic cell counts than cows with zero, one, or two infected quarters. Among bacterial isolates, Staphylococcus aureus-infected quarters had the highest (P < .01) milk somatic cell count. Percentages of butterfat and lactose were lower (P < .01) in milk from infected quarters than from uninfected quarters. Infections by S. aureus and coagulase-negative staphylococci were the most common and accounted for 67 to 78% of the infections. Percentages of infected quarters and infections caused by S. aureus increased with parity (P < .01). Intramammary infections did not affect (P > .10) calf weaning weight. In conclusion, intramammary infection had no effect on calf weaning weight but increased milk somatic cell count and decreased the percentage of protein, lactose, solids-not-fat, and butterfat. The number of infected and blind mammary quarters increased with parity.  相似文献   

7.
Prevalence of udder infections and mastitis in 50 California dairy herds   总被引:2,自引:0,他引:2  
The California mastitis test (CMT) and bacteriologic culture were performed on samples of bulk-tank milk and cow-composite milk (n = 23,138 cows) from 50 California dairies, 19 of the 50 with known mastitis problems. Thirty-eight (76.0%) bulk-tank milk samples and 12,334 (53.3%) cows were positive by results of the CMT. Potential mastitis agents were isolated from 5,085 (22%) cows. Staphylococcus aureus was isolated from all 50 herds, Streptococcus agalactiae was isolated from 47 herds, and Mycoplasma sp was isolated from 24 herds. For cow-composite milk samples, the prevalences were 9.3% for Str agalactiae, 9.1% for S aureus, 0.9% for Mycoplasma sp, 1.2% for coliform bacteria, 0.9% for other streptococci, 0.8% for coagulase-negative staphylococci, and 1.3% for other organisms. The relative sensitivity and the relative specificity of the CMT performed on cow-composite milk samples were 83.4% and 55.2%, respectively, and the predictive value of positive CMT results was 34.2%.  相似文献   

8.
Experimental infections were produced in 78 quarters of 17 cows by the infusion of small numbers of a single strain of Staphylococcus aureus. In each single experiment three quarters in a cow were infected, with the fourth left as a control. At times varying from three to 60 days after the infusion of organisms, a standard intramammary antibiotic treatment was administered on a single occasion. A cure was arbitrarily defined as the absence of the organism in foremilk, from direct plating and replated incubated milk, together with return to normal somatic cell count levels as determined by an electronic counter.

With these standardized conditions the effects of a number of cow associated factors on the outcome of the therapy were determined.

Forty-three of the 78 quarters (55%) were cured by the standard treatment. Significant differences in percentages of quarters cured were found to be associated with the duration of infection before therapy, the lactation age of the cow, the length of time in lactation, somatic cell count in milk at time of treatment, the location of the quarter in the udder and individual cows. No significant effects on the outcome of the standard treatment were found associated with the number of bacteria in the secretion at the time of treatment, previous infection and cure in a quarter nor the season of the year in which treatment was given. Of the 35 quarters in which infection recurred following treatment, organisms were reisolated from 12 within four days, 18 between five and nine days, four between ten and 17 days and one after 28 days.

From these data it is apparent that if, as has been suggested, models such as described are to be used for efficacy trials, standardization of some parameters is essential.

  相似文献   

9.
Diagnosis of bacterial septicemia was confirmed by results of bacteriologic culture of antemortem blood samples and/or necropsy specimens obtained from 47 foals up to 8 days old. Gram-negative bacteria were isolated from all 47 foals, and mixed infections with more than one organism were involved in 26 (55%). Escherichia coli, Actinobacillus spp, and Klebsiella pneumoniae were the most frequent isolates, infecting 55, 34, and 23% of foals, respectively. Gram-positive bacteria and anaerobic bacteria were isolated only from foals with mixed infections with gram-negative organisms. Clostridium perfringens was the only anaerobe isolated. In 38 (81%) of 47 foals with confirmed septicemia, blood samples were culture-positive. Thirty-two septicemic foals subsequently died, allowing a comparison to be made between the species of bacteria isolated by culture of blood with those recovered by culture of internal organs at necropsy. Blood failed to yield any gram-negative organisms in 12 (37.5%) of 32 foals from which a gram-negative pathogen was isolated at necropsy. Forty-three percent of the gram-negative bacteria, including 59% of the E coli, and 10% of the gram-positive bacteria found in septicemic foals at necropsy were not detected earlier by results of bacteriologic culture of blood.  相似文献   

10.
Occurrence of Prototheca zopfii, a mastitis pathogen, in milk   总被引:1,自引:0,他引:1  
Prototheca zopfii was isolated from cow-composite milk and bulk tank milk by a new selective Prototheca enrichment method. Repeated testing of cow-composite milk from individual cows resulted in P. zopfii isolation data indicating a strong statistical correlation of P. zopfii with specific cows. Prototheca sp. were isolated from the milk of 31 of 79 cows in a single herd, and contamination was discounted as the source. Prototheca sp. were also recovered from 28 of 787 bulk tank milk samples from the Eastern U.S.A., and 22 of 69 temperature control milk samples from pooled dairy farm milk from delivery trucks.  相似文献   

11.
Staphylococci are a major cause of intramammary infections (IMI) in ruminants. The main aim of this study was to investigate staphylococcal IMI in dairy cattle with emphasis on persistence and distribution of staphylococcal species and genotypes. With a sampling interval of 4-8 weeks, over a year, 4030 samples from 206 cows in 4 herds were collected. Coagulase-negative staphylococci (CNS) and Staphylococcus aureus were detected in 13.2% and 4.2% of the samples, respectively. Selected CNS isolates from quarter milk samples were identified to species level using sodA sequencing. Staphylococcus chromogenes (32%) and Staphylococcus simulans (25%) predominated. The proportion of S. chromogenes was greater in primiparous (52%) than in multiparous cows (12%), while the opposite was the case for Staphylococcus epidermidis (6% and 21%, respectively). Isolates from possibly persistent IMI were selected for pulsed-field gel electrophoresis (PFGE). Six staphylococcal species were found to cause persistent IMI; S. aureus, S. chromogenes, S. simulans, S. epidermidis, Staphylococcus haemolyticus and Staphylococcus warneri. It was shown that several pulsotypes (PTs) within each species were associated with persistent infections, but only a few were spread and caused persistent IMI in multiple cows within a herd. Of special interest was the observation that only one, or a few, strains of each species caused persistent IMI in multiple cows within a same herd. This indicates strain differences with respect to transmissibility and pathogenicity.  相似文献   

12.
There is limited information on the value of antibiotic therapy for mastitis in beef cows. Effects of antibiotic treatment at weaning and the subsequent calving on calf weaning weight, milk somatic cell counts, milk components, and intramammary infection were studied in beef cows. Additionally, effects of number of infected mammary quarters, number of dry mammary quarters, type of intramammary pathogen, and parity on response variables were determined. Cows (n = 192) were randomly assigned to treatments in a 2 x 2 factorial arrangement; factors were time of treatment (weaning and after calving) and treatment (vehicle and vehicle plus antibiotic). Oxytetracycline (LA-200) or vehicle was administered intramuscularly following collection of quarter milk samples at weaning and calving. Percentage of infected cows and quarters averaged 43.4 and 16.4%, respectively, at calving and increased (P < 0.05) to 53.7 and 29.7% at weaning. Calves from cows with one or two dry quarters weighed 12.7 kg less (P < 0.05) at 90 d after calving and 18.7% less (P < 0.05) at 212 d after calving than calves from cows with no dry quarters. Calves from cows with three or four infected quarters weighed 17.5 kg less (P < 0.05) at 90 d and 25.5 kg less (P < 0.05) at weaning than calves from cows with two or fewer infected quarters. Infections by Staphylococcus aureus and coagulase-negative staphylococci were the most common and accounted for 67 and 78% of the infections. Percentages of infected cows and quarters, infections caused by S. aureus, and dry quarters increased (P < 0.05) with parity. No differences were found among antibiotic treatments for any of the response variables studied. Intramuscular oxytetracycline was not effective in the control of mastitis in beef cows under the conditions of the study.  相似文献   

13.
OBJECTIVE: To determine factors associated with implementation and use of an on-farm system for bacteriologic culture of milk from cows with lowgrade mastitis, including information on how producers used the on-farm bacteriologic culture system to guide antimicrobial selection practices and the resulting impact on patterns of antimicrobial use. DESIGN: Retrospective cohort study. SAMPLE POPULATION: Producers of 81 dairy farms. PROCEDURE: Farms that used an on-farm system for bacteriologic culture of milk from January 2001 to July 2003 were surveyed. RESULTS: Over half of those producers continuing to use the on-farm culture delayed antimicrobial treatment pending results of bacteriologic culture. Most other producers initiated empirical antimicrobial treatment while bacteriologic culture results were pending. Several barriers to the use of an on-farm system were identified. Significant reductions in rates of antimicrobial use were detected when comparing antimicrobial use rates before and during use of the on-farm system. Most producers chose to treat cows with mastitis caused by gram-positive pathogens with antimicrobials, whereas treatment choices for cows with mastitis caused by gram-negative bacteria and in cases in which no growth was detected varied. CONCLUSIONS AND CLINICAL RELEVANCE: Readily available results permit antimicrobial selections to be made on the basis of the causative agent of mastitis. Adoption of an on-farm system for bacteriologic culture of milk may result in significant reductions in the percentage of cows treated with antimicrobials. Decreasing antimicrobial use may have several benefits including preventing unnecessary discarding of milk, decreasing the potential for drug residues in milk, and improving treatment outcomes as a result of targeted treatments.  相似文献   

14.
An enzyme-linked immunosorbent assay (ELISA) was evaluated for diagnosis of experimental or naturally occurring Fasciola sp. infections in cattle. The positive rate for the ELISA in calves inoculated with Fasciola metacercariae were 21.1% by 2 weeks postinoculation (PI), 94.6% by 4 weeks PI and 100% by 6-21 weeks PI. The positive rate for the immunodiffusion test (Ouchterlony test) reached 91.7% by 2 weeks PI, however, it dropped to 77.8% by 10 weeks PI. The positive rate for the fecal egg examination was 0% by 10 weeks PI, 77.8% by 12 weeks PI and 100% by 14-21 weeks PI. The practical application of ELISA was tested by using 165 cows raised under field condition. All the 24 cows that were positive both in the fecal egg examination and the Ouchterlony test were ELISA positive. Of the 6 cows that were egg positive and Ouchterlony negative, 5 showed ELISA positive reactions. Of the 27 cows that were egg negative and Ouchterlony positive, 24 were ELISA positive. Of the 108 cows that were egg negative and Ouchterlony negative, 90 were ELISA negative. However, the other 18 cows had ELISA positive reactions. Our results suggested that the ELISA using crude adult antigen was superior to the Ouchterlony test and fecal egg examination for diagnosis of experimental or naturally occurring Fasciola sp. infections in cattle.  相似文献   

15.
AIM: To identify fungi isolated from infections of the bovine mammary gland, and establish their possible sources.

METHODS: From a herd of 420 cows, milk samples were collected from all quarters at calving and cultured to detect causative organisms. Quarters identified as infected with fungi were further sampled during early lactation. Samples from feedstuffs, the feed pad and ends of teats were also collected and analysed for the presence of fungi.

RESULTS: Eleven of 420 cows were diagnosed with intramammary infections (IMI) caused by yeasts (nine cows, 10 quarters) and moulds (two cows, three quarters). Six of the yeast species had previously been reported as being responsible for mastitis. Elevated somatic cell counts (SCC) were observed in many quarters, but most infections were eliminated spontaneously. Two of the fungi isolated from milk samples were also isolated from feedstuffs and teat swabs, and seven other fungi isolated from milk samples were not isolated from feed, the feed pad or cows' teats.

CONCLUSIONS: Isolation of fungi from the udder is rarely reported in dairy cows in New Zealand. In this herd, contamination of the end of the teat originating from feedstuffs and possibly exacerbated by the use of a feed pad may have led to the establishment of IMI caused by fungi.

CLINICAL RELEVENCE: Fungi are infrequently if ever reported in mastitis trial data or surveys in New Zealand and are probably of little clinical significance.  相似文献   

16.
AIM: To identify fungi isolated from infections of the bovine mammary gland, and establish their possible sources. METHODS: From a herd of 420 cows, milk samples were collected from all quarters at calving and cultured to detect causative organisms. Quarters identified as infected with fungi were further sampled during early lactation. Samples from feedstuffs, the feed pad and ends of teats were also collected and analysed for the presence of fungi. RESULTS: Eleven of 420 cows were diagnosed with intramammary infections (IMI) caused by yeasts (nine cows, 10 quarters) and moulds (two cows, three quarters). Six of the yeast species had previously been reported as being responsible for mastitis. Elevated somatic cell counts (SCC) were observed in many quarters, but most infections were eliminated spontaneously. Two of the fungi isolated from milk samples were also isolated from feedstuffs and teat swabs, and seven other fungi isolated from milk samples were not isolated from feed, the feed pad or cows' teats. CONCLUSIONS: Isolation of fungi from the udder is rarely reported in dairy cows in New Zealand. In this herd, contamination of the end of the teat originating from feedstuffs and possibly exacerbated by the use of a feed pad may have led to the establishment of IMI caused by fungi. CLINICAL RELEVENCE: Fungi are infrequently if ever reported in mastitis trial data or surveys in New Zealand and are probably of little clinical significance. KEY WORDS: Fungi, yeast, mould, bovine, intramammary infection, somatic cell count, mastitis.  相似文献   

17.
The necropsy records of dairy cows with mastitis were reviewed from the provincial veterinary laboratory in Guelph (44 cases of mastitis in nine years) and from the Ontario Veterinary College (168 cases in 14 years). Mastitis was considered to be the primary cause of death in 167 of 212 cows (79%). Of these 167 cases of mastitis, Escherichia coli was involved in 107 (64%), Klebsiella sp. in 12 (7%) and Staphylococcus aureus in 11 (7%). Bacteriology was not reported in 22 cases. Coliform mastitis, the most commonly identified type of fatal mastitis, was characterized histologically by the presence of infarcted areas in affected glands and by the lack of demonstrable bacteria, and was thus easily identified from fatal mastitis caused by S. aureus.  相似文献   

18.
In a survey of about 3000 dairy cows producing low somatic cell count (SCC) milk and kept on a large-scale dairy farm, California Mastitis Test (CMT) positivity was found in 2714 udder quarters of 1491 cows. Pathogenic microorganisms were isolated from 57.6% of these 2714 udder quarters during bacteriological examination. The commonest pathogens were coagulase-negative staphylococci (CNS, 41%) and Staphylococcus aureus (32.5%); however, udder infections caused by environmental streptococci (12.8%) and coliform bacteria (6.8%) were also common. All pathogens resulted in a significant increase of the SCC in individual bulk milk (IBM) samples. In the case of CNS, this SCC elevation in IBM was significantly lower than in the case of infection by the other pathogens. In spite of this, because of the high number of udder infections caused by CNS, the adverse effect exerted by CNS on dairy herds is considered to be substantial. It was found that 54.6% of all CMT-positive cows produced IBM of an SCC below 400 thousand per ml. The milk produced by 41% of the 315 cows excreting S. aureus also had an SCC below 400 thousand per ml. This poses a serious risk of infection to the healthy herdmates. At the same time, 11% of the infected cows produced IBM with an SCC below 100 thousand per ml. On the basis of these findings, only the regular analysis of SCC of IBM can be a reliable indicator of chronic intramammary infection. As the SCC of milk produced by CMT-positive cows (and especially of those excreting pathogens) tended to increase with advancing lactation, the authors suggest that an efficient drying-off therapy should be used to restore udder health and, whenever justified, culling of cows cannot be avoided either.  相似文献   

19.
OBJECTIVE: To determine whether results of antimicrobial susceptibility testing of bacterial pathogens isolated from the milk of dairy cows with clinical mastitis were associated with duration of clinical signs or bacteriologic cure rate following treatment with cephapirin and oxytetracycline. DESIGN: Observational study on a convenience sample. ANIMALS: 58 dairy cows with 121 episodes of clinical mastitis. PROCEDURE: Cows that only had abnormal glandular secretions were treated with cephapirin alone. Cows with an inflamed gland and abnormal glandular secretions were treated with oxytetracycline and cephapirin. Cows with systemic signs of illness, an inflamed gland, and abnormal glandular secretions were treated with oxytetracycline and flunixin meglumine and frequent stripping of the affected glands. The Kirby-Bauer method was used for antimicrobial susceptibility testing, and current guidelines were used to categorize causative bacteria as susceptible or resistant to the treatment regimen. RESULTS: Median durations of episodes of clinical mastitis caused by susceptible (n = 97) and resistant (24) bacteria were not significantly different. Bacteriologic cure rates at 14 and 28 days were similar for episodes caused by susceptible and resistant bacteria; however, for 56 episodes of clinical mastitis caused by gram-positive bacteria and treated with cephapirin alone, bacteriologic cure rate at 28 days was significantly higher for susceptible than for resistant bacteria. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that antimicrobial susceptibility testing was of no value in predicting duration of clinical signs or bacteriologic cure rate in dairy cows with mastitis, except for episodes caused by gram-positive organisms treated with intramammary administration of cephapirin alone.  相似文献   

20.
The German wasp, Vespula germanica has been observed to injure teats of dairy cows, causing lesions that are associated with clinical and subclinical mastitis. The presence of skin lesions on the teats, caused by the wasps, was recorded in a dairy cattle herd located in the Samaria foothills during July-October 1999. Wasp-inflicted injuries were found in 43.6% (58 of 133) of the adult cows and 1.4% (one of 71) of the first-calving cows. They were located in 42.4% of cows (n = 25) on all quarters, 18 cows (30.5%) had lesions on the front quarters and 27.1% (n = 16) of cows on the hind quarters only. Clinical and subclinical mastitis were diagnosed in 61% (36 of 59) and 28.8% (17 of 59), respectively, of the injured adult and first-calving cows. The most common bacterial isolates from the mastitic cows were Staphylococcus aureus 45.1% (n = 14), Streptococcus dysgalactiae 16.1% (n = 5), Streptococcus spp. 19.4% (n = 7) and others 13.9% (n = 5). The loss of milk production was estimated at 300 kg milk for each cow injured by wasps and exhibiting clinical mastitis. An increase in the bulk-milk somatic cell count, from 186 x 103 at 1 month prior to the outbreak to a peak of 1200 x 10(3) in the post-outbreak month, was noted. The culling rate reached 13.6% (eight of 59) of the affected cows. In summary, the considerable economic losses caused by the wasp infestation resulted from decreased milk production and a decline in milk quality, culling of affected cows, and increased demand for use of drugs and veterinary care.  相似文献   

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