“CDC: Antibiotic Overuse Can Be Lethal” – Wall Street Journal, 4 March 2014

According to a report by the CDC, the overuse of antibiotics used to treat patients is spurring the formation of superbugs. While treatments vary between hospitals, some doctors prescribe their patients three times the amount of antibiotics that doctors in other hospitals prescribe, for comparable diseases.

The constant misuse has rendered many antibiotics ineffective and caused the rapid development of superbugs. Misuse can also make patients susceptible to other infections, like Clostridium difficile, or C. difficile, a bacterial infection.

The CDC’s report gathered information from hospitals and patients from 2010 and 2011. The report projected that reducing antibiotic use by 30% would lower C. difficile infections by 26%. Almost 250,000 patients contract C. difficile in the hospital, which can bring on sepsis and death.

A very powerful antibiotic that is often overused is vancomycin, which is prescribed for MRSA, a strain of Staph infection. In a study, over 20% of patients who were treated with intravenous vancomycin for MRSA never had MRSA.

The government is pushing to half the amount of C. difficile infections in five years. Doing so would prevent 20,000 deaths, 150,000 hospitalizations and cut $2 billion dollars from health-care expenses.

Obama also addressed this situation in his budget proposal for 2015, which contains $30 million to study and pinpoint strains of resistant bacteria, and promote communication between communities about outbreaks and remedies.

April 12, 2014

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“Antibiotics of the Future” – Wall Street Journal, 16 December 2013

Misuse of antibiotics in people and livestock is rampant, and has caused the formation of antibiotic-resistant germs to speed up. As a result, scientists are trying to create new antibiotics that will fight the germs that existing antibiotics can’t fight.

Scientists are using varying methods to develop new antibiotics, such as adding silver, which can increase the antibiotics’ ability to combat germs. Researchers are also employing the bacteria’s own genetic sequencing to accelerate the creation of more powerful drugs.

In the US, almost two million people are infected yearly by antibiotic-resistant bacteria, resulting in thousands of deaths. It’s natural for antibiotics to become less efficient over time: bacteria develops a resistance, which means new antibiotics need to be created regularly. Both misuse of antibiotics and a decline in antibiotic development since 1990 have added fuel to the fire.

Researchers now have the capability to develop new antibiotics by studying germs’ genomes and looking for certain gene patterns. Most antibiotics are cultivated from the bacteria’s toxins—analyzing a germs’ genes has proven to be a great, albeit slow, method to creating new antibiotics.

Researchers are also looking for ways to render germs powerless. A person becomes infected when the bacteria’s population grows to a certain amount; scientists are trying to figure out if there’s a way to break communication between the individual microbes. In addition, scientists are trying to subdue toxins and other signaling molecules that are fundamental for an infection to advance.

February 28, 2014

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Bridging the Gap between Animal Health and Human Health — NIAA Antibiotic Symposium White Paper Released

The National Institute for Animal Agriculture (NIAA) recently published a white paper for the 2013 symposium, Bridging the Gap between Animal Health and Human Health, a continuation and extension of two previous symposiums, Antibiotic Use in Food Animals: A Dialogue for a Common Purpose in 2011 and A One Health Approach to Antimicrobial Use & Resistance: A Dialogue for a Common Purpose in 2012.

The goals of the 2013 and the past symposiums have been the same, supportive of the NIAA’s mission to continue forging a new path for a strong relationship between farmers, veterinarians, experts, drug companies and others, in order to resolve antibiotic resistance.

Twenty presentations were given by a range of experts on antibiotic use and resistance, which addressed many items, including the following:

  1. Due to wide mistreatment of antibiotics and a wide array of viewpoints, our knowledge of antibiotic resistance requires further study and clarification. There are many facets to antimicrobial resistance; if you believe you have a 100% understanding, then you haven’t received an accurate explanation.
  2. The relationship between animal, human and environmental health is compelled by the following: 1) the fact that antimicrobial resistance is bound to happen—its existence is natural and present, regardless of the use of antimicrobials; 2) when an antibiotic gains access to the ecosystem, there is a possibility that it will advance antibiotic resistance.
  3. Antibiotic resistance can be transferred between animals and humans, and vice versa.
  4. Antibiotic resistance is present in livestock, humans and companion animals, or pets.
  5. Antibiotic resistance is a global issue, not just an issue in the US.
  6. Meat manufacturing needs to follow current regulations, including correcting our mistreatment of animal antibiotics.
  7. Working towards decreasing the prevalence of antibiotic resistance requires collaboration. We must ask ourselves, “How does human health, environmental health and animal health work together to address antibiotic use and resistance?”.
  8. And much more.

(source)

Though the symposium brought key experts in human and veterinary medicine together to debate on the best approach to solving antibiotic resistance, there is still much to be done. We must closely observe and gain a better understanding of antibiotic resistance, as well as improve the motivation for advancing new antibiotics. Antibiotic resistance doesn’t originate from one source; the best way to focus on the issue is to streamline the system and eradicate any confusion.

Read all our blog posts on Human-Animal Health

Read the Bridging the Gap between Animal Health and Human Health White Paper

January 28, 2014

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“New Antibiotics Guidelines for Livestock Producers Explained” – The Cattle Site, 7 August 2013

Use of antibiotics with livestock has been long talked about in the animal health community; and finally, the FDA is introducing antibiotic guidelines for farmers and livestock producers to follow, in order to prevent the spread of antibiotic resistance to humans.

Farmers often use antibiotics as a way to help their livestock gain weight, while also preventing disease, but farmers aren’t required to report their use of antibiotics. The misuse or overuse of antibiotics can promote antibiotic resistance in humans, transferring resistant bacteria to humans. The goal of the FDA’s new regulations is to foster appropriate use of antibiotics in livestock.

The FDA has determined which specific antibiotics will have requisite veterinary oversight. They are going to work with drug companies to reprint drug labels that claim to boost feed efficiency and growth promotion, instead highlighting disease prevention, control and treatment. In addition, the FDA will concentrate on making it easier for livestock producers to acquire Veterinary Feed Directive drugs, which are used in animal feed; the use of Veterinary Feed Directive drugs are supervised by licensed vets.

Click here for the list of antibiotics included in the call for veterinary oversight.

Read all of our entries related to Human-Animal Health.

Conceived, Developed and Written by Dr. Subodh Das and Tara Mahadevan

August 28, 2013

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“Do antibiotics in animal feed pose a serious risk to human health?” – Medical Xpress, 10 July 2013

Medicated animal feed and water, and the risk they pose to humans, is still widely debated in the agriculture industry, as many are on opposing sides.

Though there are moves to create new antibiotics that would allow for less antibiotic resistance, medical experts suggest that scaling down on antibiotic use overall should be our first step. From 2009-2011, 72% of antimicrobials sold in the US were used to medicate water and animal feed. Such additives are regularly given to animals, in order to boost growth and curb disease, and are often unnecessary since livestock are typically healthy; livestock living conditions — sometimes crowded and unhygienic — are what can encourage disease.

In April, we wrote about a new study by Britain and Denmark that showed that bacteria does indeed move from animals to humans. Denmark, the global forerunner in pork exports, seems to be an expert in the arena of antimicrobial use in livestock production: in 1994, Denmark decreased its usage of antimicrobials by 60%, while also expanding its pork production by 30%. From the British and Danish study, we can easily glean that regular antibiotic use in livestock production can breed resistance.

Politics also play a heavy hand in this debate, and contribute to an unwillingness to act.

See our previous blogs on this subject:
Antibiotics and the Meat We Eat
Study Shows Bacteria Moves From Animals to Humans
Antibiotic-Resistant Bacteria Surround Big Swine Farms in China & US

Conceived, Developed and Written by Dr. Subodh Das and Tara Mahadevan

July 11, 2013

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“Antibiotics and the Meat We Eat” – New York Times, 27 March 2013

The agricultural industry’s use of antibiotics in their livestock has been a hot button topic the last few months, and only getting hotter. While the agriculture industry overwhelmingly denies that antibiotic-resistant bacteria can be transferred from livestock to humans, a British-Danish report from last month shows that bacteria does has the ability to move from animals to humans.

As we wrote in a previous post in November, “Farm Use of Antibiotics Defies Scrutiny“, responsibility for regulating antibiotic use is splintered among multiple agencies: the FDA, USDA and CDC. The FDA polices drugs, a role they carry out by overseeing the meat sold in our supermarkets, and by monitoring the existence of bacteria that are resistant to antibiotics. The FDA is trying to get a handle on the kinds of antibiotics that are being fed to livestock, but to no avail — livestock facilities are not legally required, and are vehemently opposed, to divulge details about what drugs are administered to which animals, and in what amounts.

It seems as this point that the situation could be a matter of life and death. In 2011, the agricultural industry bought almost 30 million pounds of antibiotics — 80% of the US’s 2011 antibiotic sales — for animal use, the biggest quantity ever purchased. The drugs are mostly given to animals at low dosages in order to encourage growth, and to contain any sicknesses they might contract by living in such close quarters of each other and their waste. However, feeding livestock low levels of antibiotics can actually breeds antibiotic-resistant diseases.

In 2008, Congress forced drug companies to report to the FDA the amount of antibiotics they sold to agricultural facilities. Again, no information was released on what drugs were given to which animals, in what amounts and why.

The Senate Committee on Health, Education. Labor and Pensions reauthorized the Animal Drug User Fee Act (ADUFA) for 2013, requiring veterinary-drug companies to pay fees to the FDA as a way to financially support the agency. Two Democrats from the House have introduced new legislation that would give FDA the authority to amass more data from drug companies, as well as make food producers reveal how frequently they give low doses of antibiotics to animals, so as to spur growth and offset poor conditions.

We believe that in order to lower societal costs, and protect animals and humans, open and objective debate needs to continue among all stakeholders.

Conceived, Developed and Written by Dr. Subodh Das and Tara Mahadevan

April 29, 2013

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“Study Shows Bacteria Moves From Animals to Humans” – New York Times, 27 March 2013

A new study by Britain and Denmark shows that bacteria does indeed move from animals to humans, a claim constantly denied by the agriculture and food industries.

The British and Danish researchers pooled their data from two small Danish farms, and through genetic sequencing, determined that a strain of antibiotic-resistant bacteria was capable of being transmitted from animals to humans. The new report clearly shows the affect and risk that antibiotics have on both livestock and humans alike; this research is, without a doubt, the first of its kind to show a direct connection between animals and humans.

We’ve written and reported on this topic numerous times, as the link between human and animal health becomes a bigger global issue. This month, the American Humane Association is holding their first human-animal health conference in New York, which will focus on the “impact of innovation and technology and their crossover applications for human and animal health.” This is a step in the right direction for everyone involved in human and animal health sectors — consumers, scientists, veterinarians, doctors, hospitals, clinics, animal feeding operations, farmers, drug manufactures, and state, federal and international regulatory agencies  — to identify what can be done to objectively understated and improve the relationship between the human and animal health sectors.

See our previous blogs on this subject also:
Dead Pigs Worry Shanghai
Conference to Examine Transformative Effect of Innovation on Human-Animal Health
Antimicrobial Use and Resistance — NIAA Symposium White Paper Released
Antibiotic-Resistant Bacteria Surround Big Swine Farms in China & US
Farm Use of Antibiotics Defies Scrutiny

Conceived, Developed and Written by Dr. Subodh Das and Tara Mahadevan

April 2, 2013

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“Dead Pigs Worry Shanghai” – Wall Street Journal, 12 March 2013

Earlier this month, 3,300 dead pigs were found dead in the Huangpu River, which supplies water to most of Shanghai’s 23 million residents. Chinese authorities have no idea how the pigs died.

Government officials investigated any impact the pigs would have on the river and other local waters, announcing that no health threat in the water existed. However, authorities found the pig-borne disease porcine circovirus in the river, which according to the US CDC, does not affect humans. China’s main meat is pork, which consists of almost half a billion pigs, and the country littered with swine farms that are rife with communicable diseases. An industry expert noted that the dead pigs might be indicative of a disease outbreak from a single farm.

China has had its fair share of pig illnesses. In 2007, around 50 million pigs died from an outbreak of high-fever blue ear disease; and this past January, 948 Chinese pigs had to be killed due to an outbreak of foot and mouth disease.

Additionally, Chinese waterways have been exposed to much pollution. Again this past January, a chemical transporter spewed benzene into a Huangpu River tributary, which caused 20 people to be hospitalized. Earlier this year, Rivers in three northern provinces were also affected due to a chemical spill.

The chemical spills, as well as the mass deaths, are also calling Chinese food safety, environmental and air quality regulations into question. In 2011, China claimed the number one spot as the world’s biggest carbon dioxide polluter, up by 10 percent to contribute 10 billion tons of carbon dioxide emissions to the world’s atmosphere. It is no wonder that China’s air quality caused its residents to become sick, and persuaded many to wear face masks.

In our view, the land where humans and animals live, the water we drink, and the air we breathe constitute environmental quality, and all eventually contribute towards human and animal health and safety. We live in an interconnected global ecosystem that we need to keep clean and safe. China — now the largest country in the world — continues to grow its economy in order to achieve a more western lifestyle, and population, which is currently at 1.3 billion people or one-seventh of the world’s population. China will have to strike a healthy balance between economic growth and environmental harmony that many western economies are already addressing.

See also:
Carbon Pollution up to 2 Million Pounds a Second
Conference to Examine Transformative Effect of Innovation on Human-Animal Health
Antimicrobial Use and Resistance — NIAA Symposium White Paper Released
Antibiotic-Resistant Bacteria Surround Big Swine Farms in China & US

Conceived, Developed and Written by Dr. Subodh Das and Tara Mahadevan

March 28, 2013

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Antimicrobial Use and Resistance — NIAA Symposium White Paper Released

The National Institute for Animal Agriculture (NIAA), an organization geared towards developing resolutions in different areas of the animal agriculture industry, recently released a White Paper, “A One Health Approach to Antimicrobial Use & Resistance: A Dialogue for a Common Purpose“. The White Paper addresses antimicrobial use and resistance, and begins to explore methods to resolve these topics. The paper is a summary of presentations from 13 human health, animal health and environmental health scientists and professionals, and the outcome of four interactive sessions with those who attended the 2012 Antibiotics Conference in Columbus, OH.

The topic of NIAA’s paper is much similar to our recent blog post, Antibiotic-Resistant Bacteria Surround Big Swine Farms in China & US, in which researchers found that the process of resistance genes grouping and moving to other bacteria has greatly developed by the burgeoning use of antibiotics and metals on farms.

Like the researchers from our previous post, NIAA’s paper has similar reasoning for antimicrobial resistance, “Antimicrobial resistance occurs via three mechanisms, each requiring only minor changes in biochemistry: 1) Bacteria may possess enzymes that degrade antibiotics; 2) Bacteria may replace or alter the method through which the antibiotic enters the cell; and 3) Bacteria may alter the cellular target site of the antibiotic.” In a similar vein, the researchers pulled samples from swine farms in China and the US and found the presence of transposase, an enzyme that allows resistant genes to move from one bacterium to the next.

In fact, the issue of animal antibiotics is, as the White Paper puts it, a polarizing issue. The paper admits that antimicrobial resistance is about more than science and evidence, but also directly deals with politics, behavior, economics and conflicting opinions in the overarching health — animal, human and environmental — community.

In another previous blog post, Farm Use of Antibiotics Defies Scrutiny, we discussed how cooperation and communication between manufacturers and regulatory agencies is inadequate. While the FDA has attempted numerous times to standardize the use of antibiotics in livestock, it has proved problematic, as many meat manufacturers and farmers are unwilling to disclose antibiotic use. However, the relationship between the FDA and manufacturers isn’t purely to blame: it is hard to streamline antibiotic use in animals since there is nothing comparable to a national healthcare system for animals, as there is for people. What can be gleaned from these difficulties is that antibiotic use, and subsequent antimicrobial resistance, is indeed a political, behavioral, economic and combative issue.

Because the NIAA believes that animal, human and environmental health are all connected, the White Paper takes a One Health Approach: “This approach would call for all to think in a much larger dimension and work toward, improving and defending the health and well-being of all species by enhancing cooperation and collaboration between physicians, veterinarians, other scientific health and environmental professionals, and by promoting strengths in leadership and management to achieve these goals.”

The goal of the “A One Health Approach to Antimicrobial Use & Resistance: A Dialogue for a Common Purpose” Symposium was not to only understand and study the reasoning behind antimicrobial use and resistance, but to identify ways in which scientists and professional can work together and progress. The symposium had many end goals, including:

  1. To obtain the scientific facts regarding antibiotic use within animal health, human health and environmental health;
  2. to better understand the “how” and “why” antimicrobial resistance occurs;
  3. to look at alternatives to antibiotics in agriculture;
  4. lead and engage participants in open conversations;
  5. to build relationships with other sectors and gain better understanding of other perspectives;
  6. to begin to find common ground and formulate a path forward; and
  7. focus on continuous improvement and commitment to long-term health.

This white paper initiates a launching pad for data-based scientific and objective conversation, and debate among drug manufactures; human and animal health care providers; hospitals and animal feeding operations; health insurance industry, federal and state regulators; legislators and policy makers; and interest and advocacy groups. These conversations will lead towards protecting human and animal health at the lowest cost to society.

Conceived, Developed and Written by Dr. Subodh Das and Tara Mahadevan

February 25, 2013

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“Antibiotic-Resistant Bacteria Surround Big Swine Farms in China & US” – Wired, 12 February 2013

Not only does the US partake is large-scale confinement agriculture — or livestock-raising — but, as wealth and populations grow, developing countries like China and India do as well. The use of growth-promotor antibiotics began in the US and has spread to China, the world’s biggest producer and consumer of antibiotics. Half of the antibiotics China makes in-house are used in the country’s agriculture: a staggering 96 million kilograms, which is almost seven times more than the US uses every year. China’s food safety regulation is falling by the wayside, as the industry is pressurized to manufacture heaping quantities of meat and make heaping quantities of money.

In both China and the US, no regulations exist for reporting which agricultural antibiotics go into what species, and no systematized method exists to track side effects. Chinese researchers, seeing a problem, published a paper this week that addressed these issues, “Diverse and abundant antibiotic resistance genes in Chinese swine farms”.

The team visited three farms — big by Chinese standards, and from three different regions in China — to gather research for this paper. Each farm raises around 10,000 pigs every year, which, by EPA‘s definition, is on the small side of large “confined animal feeding operations.” The researchers sampled fresh pig manure from each farm: as the manure was being made into fertilizer, and from farm soil where the fertilizer had already been used. Their controls were samples of soil from a virgin forest in China, and manure from American pigs that had never taken antibiotics.

American researchers analyzed the samples to look for any antibiotic-resistant genes. The researchers detected 149 unique resistance genes, existing 192 to 28,000 times more frequently in the Chinese farm samples than in the control samples. A similar presence of transposase was found as well, an enzyme that allows resistant genes to move from one bacterium to the next.

The researchers found that the process of resistance genes grouping and moving to other bateria has greatly developed by the use of metals like zinc, copper and arsenic on farms. Additionally, resistance can be present on farms where antibiotics have never been used, even where evolutionary practices on bacteria and genes haven’t been employed.

According to the researchers’ paper, “The diversity and abundance of antibiotic resistance genes reported in this study is alarming, and clearly indicates that unmonitored use of antibiotics and metals on swine farms has expanded the diversity and abundance of the antibiotic resistance reservoir in the farm environment. The coenrichment of ARGs and transposases [enzymes] further exacerbates the risks of transfer of ARGs from livestock animals to human-associated bacteria, and then spread among human populations.”

The agriculture industry has been refuting this argument for years: if, when antibiotic resistance develops on farms, it will transfer from farms to people with no link to the farms. While the agriculture industry says no, the Chinese researchers think it’s just a question of when. As the concentration of antibiotic resistance grows, so too does the probability that it will move into the environment outside the farms.

As in any credible scientific investigations affecting animal and human health, data-based-driven debates must go on until all key stakeholders agree on a cost-effective, practical  and sustainable course of action.

Conceived, Developed and Written by Dr. Subodh Das and Tara Mahadevan

February 15, 2013

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