Herd Health Program Participation Associated with Lower Vancomycin Resistance and Multidrug Resistance in Dairy Mastitis Pathogens: A Five-Year Surveillance Study in Saraburi, Thailand.

Antimicrobial resistance in bovine mastitis pathogens poses interconnected threats to dairy productivity and public health; however, longitudinal evidence on the association between veterinary oversight and lower resistance to critically important antimicrobials in tropical smallholder systems remains limited. This study analyzed 1347 quarter milk samples from 47 dairy farms in Saraburi Province, Thailand, submitted consecutively over five years (2020-2025), to evaluate whether participation in a veterinary-led herd health (HH) program was independently associated with reduced vancomycin resistance and multidrug resistance (MDR). Bacterial identification was conducted using standard methods, and susceptibility was determined using the Kirby-Bauer disk diffusion method. Among 1069 culture-positive samples, Streptococcus spp. (25.3%) and coagulase-negative staphylococci (16.8%) predominated. Vancomycin resistance declined from 15.9% to 5.4% between early (2020-2022) and recent (2023-2025) periods. Of the 686 isolates tested against ≥3 antibiotic classes, 61 (8.9%) were MDR; vancomycin resistance co-occurred in 34.4% of these samples. Repeated logistic regression identified non-HH farm status (OR = 4.035; p = 0.027) and early-year groups (OR = 4.611; p = 0.002) as independent risk factors for vancomycin resistance. As HH participation and year group showed a significant interaction, their joint effect for MDR was modeled: compared with non-HH farms in the early period (reference), all other combinations-including HH farms in 2023, HH farms in 2020, and non-HH farms in 2023-were associated with significantly lower odds of MDR. These findings provide the first evidence from Thailand that structured veterinary herd health programs are independently associated with lower critically important antimicrobial resistance, supporting their integration into a One-Health stewardship policy.