Antibiotic-resistant ...in water - 2007

[Oscar]

Antibiotic-resistant enterococci and fecal indicators in surface water and groundwater impacted by a concentrated swine feeding operation.
Sapkota, A, F Curriero, K Gibson and K Schwabb. 2007.

Environmental Health Perspectives, in press.
http://www.environmentalhealthnews.org/ ... aetal.html

Synopsis by Dr. Edward Orlando and Wendy Hessler

Whole article free at: Antibiotic-resistant enterococci and fecal indicators in surface water and groundwater impacted by a concentrated swine feeding operation.

http://www.ehponline.org/members/2007/9770/9770.pdf

Context

At the heart of the issue is how much antibiotic use in animals influences antibiotic resistance in humans. Although bacterial resistance in people is primarily due to over prescribing of antibiotics, resistant strains from animals can transfer to people through contact at work, by eating contaminated foods or by drinking contaminated water. This study brings to light how CAFOs can pollute ground and surface waters with antibiotic resistant bacteria possibly exposing people to the microbes.

Bacterial resistance to antibiotic drugs is a big concern and a growing problem for large-scale pig yards (known as concentrated animal feedlot operations, or CAFOs) and the people who live near them. Sapkota et al. report that antibiotic resistant bacteria in both surface and groundwater is higher down stream from a swine feeding operation in the Mid-Atlantic region of the United States. The water sources below the swine feedlot also contained higher concentrations of the three types of intestinal bacteria studied – enterococci, fecal coliform and E. coli (Escherichia coli) – than the surface and groundwater tested above the facility.

The degree of antibiotic resistance varied depending on the water sample tested.

The study is important because it is one of only a few comparing the amount of fecal bacteria and the antibiotic resistance of the bacteria in surface and groundwater above and below a swine concentrated animal feeding operation or CAFO. The results show that waste from a swine CAFO can contribute antibiotic-resistant fecal bacteria to natural water systems.

Antibiotics are given to animals to increase their growth. Intestinal bacteria can become resistant to the drugs. The microbes leave the animal in fecal matter and can get into the environment through leaking storage pits and runoff from fields when manure is used as a fertilizer. Humans may become ill or need longer or more potent antibiotic treatment if they are exposed to the resistant microbes.

Although the European Union banned use of antibiotics for growth promotion in January 2006, the United States has not. The US Food and Drug Administration, the government agency that regulates antibacterial use in animals, does not have accurate information about what kinds, how much and where antibiotics are being used across the country. It is estimated, though, that animals raised for food in the US are given 25 million pounds of antibiotics annually just to promote growth and over 10 million pounds of antibiotics in swine production alone (Gilchrist et al. 2007). Today, most animal antibiotics are available over the counter and each farmer decides how they will be used. But, with changing agricultural practices – CAFOs are so large and environmentally detrimental – many are questioning that wisdom and scrutinizing the self-governing approach.

What did they do?

From 2002 – 2004, Sapkota et al. collected 28 surface and groundwater samples from a pond, streams and wells located up- and down stream of a swine CAFO. They examined the samples for three types of bacteria found in animals and people: fecal coliformes, E. coli and enterococci (several species). Fecal coliformes are rod-shaped gut bacteria found in animals and people, whereas enterococci are spherical-shaped bacteria.

They tested resistance to five antibiotics: erythromycin, tetracycline, clindamycin, virginiamycin, and vancomycin. All except vancomycin are FDA approved for swine production in the United States.

To compare anti-biotic resistance among bacteria obtained from different sampling locations, Sapkota et al. determined the lowest dose of antibiotic that was sufficient to prevent bacterial growth. This is called the minimal inhibitory concentration (MIC).

What did they find?

Bacterial levels were much higher downstream of the feed-lot, both in surface and groundwater. Median concentrations of enterococci species, E. coli, and fecal coliform were 17-, 11-, and 33-fold greater in the surface waters and 4-, 11-, and 20-fold greater in the groundwater downstream of the swine CAFO.

With few exceptions, bacteria downstream of the feedlot had higher resistance to antibiotics. For example, the dose of erythromicin needed to prevent growth in enterococci was 128-fold higher for bacteria collected in groundwater downstream compared to upstream.

Sapkota et al. also determined the percentage of Enterococcus species that were resistant to the different antibiotics, and compared upstream and downstream percentages. Six of ten comparisons showed higher resistance downstream. Of those, 2 were statistically significant (Erythromycin in groundwater and surface water) while 2 were marginally significant (Clindamycin in surface water and Tetracyclin in groundwater). Three of ten had higher percentages of the upstream samples, but only 1 was statistically significant (Clindamycin in groundwater).

A combination of economic pressure to control the costs of meat production in developed nations and a rapidly growing demand for meat in developing nations is changing the traditional agricultural practices of raising livestock (Naylor et al. 2005). In the past, beef cattle, dairy cows, swine, poultry and other livestock were fed mainly by grazing in the fields and supplemented with farm-raised grain. Animal waste, in turn, was used to fertilize the fields and provide needed nutrients and humus to the crops. Today, there is a growing trend to centralize and concentrate the husbandry of livestock in animal feeding operations, where livestock are housed in enclosed buildings or fenced enclosures and food is brought to them (Naylor et al. 2005; US EPA 2003).

In the United States, animal feeding operations of a certain size (livestock specific), or with known connections to surface waters or potential to discharge waste, are called CAFOs. There is a growing concern for the environmental impact of CAFOs (US EPA 2003, Gilchrist et al. 2007). CAFOs are relatively large agricultural units that raise animals under high density and often under controlled environmental conditions. CAFOs are defined by the type of animal raised and how the animals are housed, but include commonly raised agricultural animals such as beef cattle, dairy cows, poultry and swine.

Unless you live near a CAFO, it is perhaps difficult to understand how these large feedlots impact the areas next to them. In the Midwest, and areas of the Mid-Atlantic, the Carolinas, and California in the United States, CAFOs containing thousands to hundreds of thousands of beef cattle or dairy cows, swine or poultry are impacting the environment and have the potential to negatively affect human health. As the source of this impact, the animal waste contains natural and synthetic hormones, nutrients such as nitrates and phosphates, metals, antibiotics, antibiotic resistant bacteria, dust and odor (Hamscher et al. 2003; Naylor et al. 2005)

The concentration of animals in a small area increases the likelihood of them developing and transmitting disease. To reduce losses due to disease, farmers often treat livestock with prophylactic antibiotics. Overuse and misuse of these antibiotics has raised concerns for the development of resistant strains of intestinal tract bacteria that could spread into surface and groundwater from leaking animal waste storage pits or from waste applied to the land.

What does it mean?

Sapkota et al. report elevated concentrations of enterococci, E. coli and fecal coliform – all indicators of fecal contamination in the surface and groundwater adjacent to a swine CAFO. Furthermore, the enterococci species generally displayed higher resistance to four antibiotics approved by the FDA for swine production. This study shows that CAFOs do indeed have the potential to not only be a source of nutrients, hormones, dust, and odor, but may lead to the presence of antibiotic resistant bacteria in the surface and groundwater abutting these facilities.

The researchers have demonstrated a probable link from CAFOs to surface and groundwater contamination with antibiotic resistant bacteria, but point out that the study does not prove a linkage to the adjacent swine CAFO. The researchers were not able to confirm the use of the antibiotics used in this study by the owners of the swine CAFO nor were they able to get permission to collect up gradient surface water from the stream that was above the swine CAFO as this was on the farmer’s property and unavailable to the researchers.

This study while imperfect, demonstrates that CAFOs can be sources of antibiotic resistant enteric bacteria that can lead to compromised environmental and potentially human health in ecosystems and populations adjacent to CAFOs.

Resources:

Centers for Disease Control and Prevention. Antibiotic and antimicrobial resistance. http://www.cdc.gov/drugresistance/

Gilchrist M, C Greko, D Wallinga, G Beran, D Riley and P Thorne. 2007. The potential role of concentrated animal feeding operations in infectious disease epidemics and antibiotic resistance. Environmental Health Perspectives 115(2):313-316.
http://www.pubmedcentral.nih.gov/articl ... id=1817683

Hamscher G, HT Pawelzick, S Sczesny, H Nau and J Hartung. 2003. Antibiotics in dust originating from pig-fattening farm: a new source of health hazard for farmers? Environmental Health Perspectives 111(13):1590-1594.
http://www.ehponline.org/docs/2003/6288/abstract.html

Naylor R, H Steinfeld, W Falcon, J Galloway, V Smil, E Bradford, et al. 2005. Losing the links between livestock and land. Science 2005:1621-1622.
http://www.sciencemag.org/cgi/content/s ... /5754/1621

Woodman, R. 1999. Overuse of animal antibiotics threatens human health. British Medical Journal. 319(7209): 536.
http://www.pubmedcentral.nih.gov/articl ... id=1116432

US Environmental Protection Agency. 2003. National pollution discharge elimination system permit regulation and effluent limitation guidelines and standards for concentrated animal feeding operations (CAFOs). Final Rule. Federal Register, February 12, 2003. 68 (29):7175-7274.
http://www.epa.gov/fedrgstr/EPA-WATER/2 ... /w3074.htm

US Food and Drug Administration. Antibiotic resistance.
http://www.fda.gov/oc/opacom/hottopics/anti_resist.html


CAFOs and antibiotic resistance in the news

18 May - CAFOs increase antibiotic resistance in bacteria in downstream waters. Scientists report that bacterial resistance to antibiotics important for fighting human disease is heightened in ground and surface waters downstream of a factory pig farm. Environmental Health News.
http://www.environmentalhealthnews.org/ ... aetal.html

28 December - Big farms have big impacts--and solutions? Farms that raise poultry, swine, and cattle at an industrial scale also have industrial kinds of environmental impacts Environmental Science & Technology.
http://pubs.acs.org/subscribe/journals/ ... cafos.html

24 November - Don't Ease Rules For Factory Farms. When does a lame duck stink? When it's Congress, during the last few days that Republicans can prevail, trying to ram through exemptions for the rank odors and discharges from factory farms. Detroit Free Press, Michigan.
(Please note: unable to locate the original source of this article. EH)

17 November - The potential role of CAFOs in infectious disease epidemics and antibiotic resistance. The industrialization of livestock production and the widespread use of non-therapeutic antimicrobial growth promotants has intensified the risk for the emergence of new, more virulent, or more resistant microorganisms. Environmental Health Perspectives.
http://www.ehponline.org/docs/2006/8837/abstract.html

17 May - Many little piggies, handled with care. Russ Kremer, a fifth-generation pig farmer, had an experience that awoke him to the fact of resistance to antibiotics in livestock and the significant health risk it posed to humans. So he went cold turkey. New York Times.
http://select.nytimes.com/gst/abstract. ... 94DE404482


More news about CAFOs
http://www.environmentalhealthnews.org/ ... ext5;CAFOs
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© Environmental Health Sciences. Articles may be used for educational and other not-for-profit purposes with credit to Environmental Health Sciences.

[Oscar]

MRSA Superbug Infections Now Killing More Americans than AIDS

To: Fed. Health Min. Clement ; Fed. Environ. Min. Baird ; Fed. Ag.Min. Ritz ; Breitkreuz, G. MP ; Cathy Holtslander

Sent: Wednesday, March 12, 2008 8:28 AM

Subject: MRSA Superbug Infections Now Killing More Americans than AIDS


...not surprisingly, antibiotic-resistant bacteria are on the rise! They're in our food and in our water.

...the source?

Hogs produced while trapped inside "pig factories" - mega barns - receive low doses of antibiotics daily - simply to keep them alive long enough to walk into the slaughter house!

Poultry are also raised in "factories" and also receive low doses of antibiotics daily.

This practice produces bacteria which, over time, have become resistant to many of our common antibiotics and until animals are raised where they belong, outside, in the fresh air and sunshine, where there is no need for antibiotics unless they're sick, this problem will only get worse.

Many of these antibiotics are the same ones used to save human lives...but only if the patient isn't immune to the antibiotic in question, as in MRSA!

Anybody doing anything about it?

Nope.

Elaine Hughes, Spokesperson
Stop the Hogs Coalition
Archerwill, SK

See http://forum.stopthehogs.com/phpBB2/viewtopic.php?t=452

===========================================

MRSA Superbug Infections Now Killing More Americans than AIDS

http://www.naturalnews.com/z022806.html

by David Gutierrez March 10, 2008

(NaturalNews) An antibiotic-resistant strain of the common staph bacteria is now responsible for more deaths in the United States than AIDS, according to a study conducted by the Centers for Disease Control and Prevention (CDC) and published in the Journal of the American Medical Association. "This is a significant public health problem" said CDC medical epidemiologist Scott K. Fridkin. "We should be very worried."

Methicillin-resistant Staphylococcus aureus (MRSA) is a variant of a common bacteria species that normally causes easily-treated staph infections. While staph infections are not usually life-threatening, if untreated they can cause wounded flesh to necrotize (die), leading to painful and disfiguring abscesses. In severe cases, the bacteria can spread to other parts of the body, such as joints, bones, lungs, blood or other vital organs. This can cause potentially fatal complications, and patients so infected must be given intensive care immediately.

Because MRSA is resistant to all first-line antibiotics, it is far more dangerous than the easily treated varieties of the bacterium. And according to the CDC, MRSA infection is becoming more common.

Researchers analyzed data from nine states and concluded that 31.8 out of 100,000 U.S. residents are being infected by MRSA each year, leading to 94,360 infections and 18,650 deaths across the country. This is in comparison to 12,500 deaths from AIDS in 2005, and represents more infections than meningitis, bacterial pneumonia and flesh-eating strep put together.

"This indicates these life-threatening MRSA infections are much more common than we had thought," Fridkin said.

The CDC says that MRSA infections are most common among children and the elderly, and more common among blacks than among members of other ethnic or racial groups.

Prior studies on MRSA have concluded that health care providers could significantly reduce the spread of the disease by implementing stricter hygiene measures. Outbreaks of MRSA in prisons, schools, and other institutions have also become increasingly common.

"MRSA outbreaks are entirely the fault of the conventional medical community, which has actually encouraged the breeding of the bacteria through rampant overuse of antibiotics," said consumer health advocate Mike Adams. "The rest of the story is that MRSA is easily killed by colloidal silver, garlic, rainforest herbs and numerous other natural remedies, but the entire conventional medical community continues to pretend these substances don't exist. Thus, they refuse to embrace the actual cures for MRSA, and thousands of people are dying each year as a result. This medical catastrophe will continue for as long as doctors remain ignorant about the curative powers of natural remedies while remaining foolishly limited to the use of patented pharmaceuticals to treat all infections," Adams said.

[Oscar]

The Hidden Link Between Factory Farms and Human Illness

http://www.truthout.org/022009HA

by: Laura Sayre, Mother Earth News February/March 2009 Issue

The rising global demand for meat and poultry is putting human health at risk.

You may be familiar with many of the problems associated with concentrated animal feeding operations, or CAFOs. These "factory farm" operations are often criticized for the smell and water pollution caused by all that concentrated manure; the unnatural, grain-heavy diets the animals consume; and the stressful, unhealthy conditions in which the animals live.

You may not be aware, however, of the threat such facilities hold for you and your family's health - even if you never buy any of the meat produced in this manner.

Factory farms are breeding grounds for virulent disease, which can then spread to the wider community via many routes - not just in food, but also in water, the air, and the bodies of farmers, farm workers and their families. Once those microbes become widespread in the environment, it's very difficult to get rid of them.

A 2008 report from the Pew Commission on Industrial Farm Animal Production, a joint project of the Pew Charitable Trusts and the Johns Hopkins Bloomberg School of Public Health, underscores those risks. The 111-page report, two years in the making, outlines the public health, environmental, animal welfare and rural livelihood consequences of what they call "industrial farm animal production." Its conclusions couldn't be clearer. Factory farm production is intensifying worldwide, and rates of new infectious diseases are rising. Of particular concern is the rapid rise of antibiotic-resistant microbes, an inevitable consequence of the widespread use of antibiotics as feed additives in industrial livestock operations.

Scientists, medical personnel and public health officials have been sounding the alarm on these issues for some time. The World Health Organization and the Food and Agriculture Organization (FAO) have
recommended restrictions on agricultural uses of antibiotics; the American Public Health Association (APHA) proposed a moratorium on CAFOs back in 2003. All told, more than 350 professional organizations - including the APHA, American Medical Association, the Infectious Diseases Society of America, and the American Academy of Pediatrics - have called for greater regulation of antibiotic use in livestock. The Infectious Diseases Society of America has declared antibiotic-resistant infections an epidemic in the United States. The FAO recently warned that global industrial meat production poses a serious threat to human health.

The situation is akin to that surrounding global climate change four or five years ago: near-universal scientific consensus matched by government inaction and media inattention. Although the specter of pandemic flu - in which a virulent strain of the influenza virus recombines with a highly contagious strain to create a bug rivaling that responsible for the 1918 flu pandemic, thought to have killed as many as 50 million people - is the most dire scenario, antibiotic resistance is a clear and present danger, already killing thousands of people in the United States each year.

People, Animals and Microbes

From one perspective, picking up bugs from our domesticated animals is nothing new. Approximately two-thirds of the 1,400 known human pathogens are thought to have originated in animals: Scientists think tuberculosis and the common cold probably came to us from cattle; pertussis from pigs or sheep; leprosy from water buffalo; influenza from ducks.

Most of these ailments probably appeared relatively early in the 10,000-year-old history of animal domestication. Over time, some human populations developed immunity to these diseases; others were eventually controlled with vaccines.

Some continued to kill humans until the mid-20th century discovery of penicillin, a miracle drug that rendered formerly life-threatening infections relatively harmless. Other antibiotics followed, until by the
1960s leading researchers and public health officials were declaring that the war on infectious diseases had been won.

Beginning in the mid 1970s, however, the numbers of deaths from infectious diseases in the United States started to go back up. Some were from old nemeses, such as tuberculosis, newly resistant to standard
antibiotic treatments; others were wholly novel.

"In recent decades," writes Dr. Michael Greger, director of public health and animal agriculture for the Humane Society of the United States and author of Bird Flu: A Virus of Our Own Hatching, "previously unknown diseases have surfaced at a pace unheard of in the recorded annals of medicine: more than 30 newly identified human pathogens in 30 years, most of them newly discovered zoonotic viruses." (Zoonotic viruses are those that can be passed from animals to humans.)

Why is this happening?

There are many reasons, including the increased pace of international travel and human incursions into wild animals' habitats. But one factor stands out: the rise of industrial farm animal
production. "Factory farms represent the most significant change in the lives of animals in 10,000 years," Greger writes. "This is not how animals were supposed to live."

Chicken and pig production are particularly bad. In 1965, the total U.S. hog population numbered 53 million, spread over more than 1 million pig farms in the United States - most of them small family operations. Today, we have 65 million hogs on just 65,640 farms nationwide. Many of these "farms" - 2,538, to be exact - have upwards of 5,000 hogs on the premises at any given time. Broiler chicken production rose from 366 million in 1945 to 8,400 million in 2001, most of them in facilities housing tens of thousands of birds.

On a global scale, the situation is even worse. Fifty-five billion chickens are now reared each year worldwide. The global pig inventory is approaching 1 billion, an estimated half of which are raised in confinement. In China and Malaysia, it's not unheard of for hog facilities to house 20,000 or even 50,000 animals.

The Mechanics of Resistance

"Concentrated animal feeding operations are comparable to poorly run hospitals, where everyone is given antibiotics, patients lie in unchanged beds, hygiene is nonexistent, infections and re-infections are rife, waste is thrown out the window, and visitors enter and leave at will," write Johns Hopkins researchers Ellen Silbergeld, Jay Graham and Lance Price in the 2008 Annual Review of Public Health. By concentrating large numbers of animals together, factory farms are terrific incubators for disease. The stress of factory farm conditions weakens animals' immune systems; ammonia from accumulated waste burns lungs and makes them more susceptible to infection; the lack of sunlight and fresh air - as well as the genetic uniformity of industrial farm animal populations - facilitates the spread of pathogens.

The addition of steady doses of antibiotics to this picture tips the balance from appalling to catastrophic. Poultry producers discovered by accident in the 1940s that feeding tetracycline fermentation byproducts
accelerated chickens' growth. Since then, the use of antibiotics as feed additives has become standard practice across much of the industry. The Union of Concerned Scientists estimates that non-therapeutic animal agriculture use (drugs given to animals even when they are not sick) accounts for 70 percent of total antibiotic consumption in the United States.

The medical community has been cautioning for years against irresponsible antibiotic use among people, but in terms of sheer numbers, livestock use is far more significant. It's a simple scientific fact that
the more antibiotics are used - especially prolonged use at low doses as in factory farms - the more antibiotic-resistant microbes will become.

Bacteria and viruses are also notoriously promiscuous, swapping genes across species and even across genera, creating what the Johns Hopkins researchers call "reservoirs of resistance." "In some pathogens, selection for resistance also results in increased virulence," they note. In other cases, otherwise harmless microbes can transfer resistance genes to pathogenic species.

There also are indications that factory farm conditions make animals more likely to excrete pathogenic microbes - suggesting another mechanism by which conversion to more humane farming methods would offer greater protection for human health.

Routes of Transmission

Most so-called bio-containment procedures for confinement livestock operations are more concerned with protecting the crowded animals from disease outbreaks than from preventing human pathogens from escaping into the wider environment. As the report from the Pew Commission points out, every step in the industrial farm animal production system holds the potential for disease transmission, from transportation and manure handling, to meat processing and animal rendering.

The increasingly globalized nature of the farm animal production system means that live animals, as well as fresh and frozen meat, are constantly crossing international borders, ensuring that diseases present in one location will soon spread elsewhere. But the biggest transmission route is waste: Confined livestock operations in the United States produce three times as much waste each year as our country's entire human population - and yet all that manure is much more loosely regulated and handled than human waste. Antibiotic-resistant microbes, as well as the antibiotics themselves, are now widely present as environmental contaminants, with unknown consequences for everything from soil microorganisms to people. Canada's largest waterborne disease outbreak, which infected 1,346 people and killed six, was traced to runoff from livestock farms into a town's water supply. The U.S. Geological Survey found antimicrobial residues in 48 percent of 139 streams tested nationwide from 1999 to 2000. Other studies have detected resistant bacteria in the air up to 30 meters upwind and 150 meters downwind of industrial hog facilities.

A wealth of evidence links industrial meat and poultry directly with foodborne illness. When dioxin-contaminated chicken feed led to the removal from the market of all chicken and eggs in Belgium for several weeks in June of 1999, doctors there noted a 40 percent decline in the number of human Campylobacter infections. Repeated studies have concluded that as much as 80 percent of retail supermarket chicken in the United States is contaminated with Campylobacter. Similarly, the Centers for Disease Control and Prevention estimates that Salmonella-contaminated eggs caused 180,000 cases of sickness in the United States in 2000. E. coli O157:H7 is blamed for 73,000 illnesses in this country each year, including about 2,000 hospitalizations and 60 deaths.

Although thorough cooking and careful handling can minimize your risks, antibiotic resistance raises the stakes when someone gets ill: "One in two human cases of Campylobacter, and one in five cases of Salmonella are now antibiotic-resistant," says Steve Roach, public health program director for the Food Animal Concerns Trust and a member of the executive committee for the Keep Antibiotics Working coalition. "And when you have antibiotic resistance, you have more complications, more blood infections, more mortality."

In fact, public health experts are beginning to suspect that a whole host of infections not previously thought of as food-related may ultimately be linked to the overuse of antibiotics in animal agriculture. Researchers at the University of California-Berkeley, for example, traced a multi-state outbreak of urinary tract infections among women in 1999 and 2000 to contamination with a single strain of drug-resistant E. coli found in cows. Dr. Lee Riley, lead author of a paper on the findings published in Clinical Infectious Diseases, cautioned that the findings indicated that "the problem of foodborne disease is much greater in scope than we had ever previously thought."

And then there's methicillin-resistant Staphylococcus aureus, or MRSA. Previously confined largely to hospitals, MRSA is now killing more people in the United States each year than HIV/AIDS. A series of recent studies in Europe have demonstrated a strong causal link between MRSA and intensive pig farming in the Netherlands, Germany and France. Little or no data are available on MRSA in animals in the United States, but the bacterium is widely present on pig farms in Canada, which sells millions of live pigs to the United States annually, so it seems pretty likely it's in U.S. pig factories, too.

All in all, the CDC reports that 2 million people in the United States now contract an infection each year while in the hospital. Of those, a staggering 90,000 die - a toll higher than that from diabetes. Numbers such as that are prompting some medical investigators to suggest that we may be entering a "post-antibiotic era," one in which (as a paper published in Environmental Health Perspectives in 2007 put it) "there would be no effective antibiotics available for treating many life-threatening infections in humans."

Connections such as these aren't always easy to prove, however, especially for drugs that have already been in widespread use for decades, which is one reason why regulations to reign in the non-therapeutic use of antimicrobials have so far been largely lacking in the United States. The pending approval of an antibiotic called cefquinome to treat respiratory diseases in cattle offered a recent test case. Cefquinome is similar to cefepime, a last-resort antibiotic used to treat serious infections in people. (Both are fourth-generation cephalosporins, one of the small number of new antibiotics developed in recent years.) The FDA's Veterinary Medicine Advisory Committee, along with the Centers for Disease Control and Prevention and the American Medical Association, recommended against approval, warning that using cefquinome for animals would almost certainly render cefepime less effective for humans. But the FDA has apparently caved to industry pressure, claiming it lacks the authority to deny the drug companies' request.

The Way Forward

Fortunately, there is a better way. No one wants high-quality food to be unaffordable, but increasingly it appears that as a human species we need to strike a better balance between cheap food and safe food. Sweden and Denmark have led the way over the past two decades in the development of commercial farming methods that minimize antibiotic use. Alternative management strategies include improving animals' diets, changing weaning practices for pigs, cleaning facilities thoroughly in between groups and being more careful about mixing animals coming from different locations.

Scandinavian producers weren't necessarily happy when their countries' ban on non-therapeutic uses of antibiotics was put in place, but they've come to realize that they can still run profitable operations without them. Researchers in this country have shown that the same is true here: In 2006, a team at Johns Hopkins used data from poultry giant Perdue to show that the small advantage in weight gain associated with non-therapeutic antibiotic use was canceled out by the cost of the drugs. Organic farmers in many parts of the world have also shown that livestock can be raised profitably and humanely without the use of antibiotics.

"This is not a necessary problem," says Lance Price, scientific advisor for Johns Hopkins' Center for a Livable Future. "If you look at all the stakeholders in this equation - you and me, the doctors and hospitals, the producers - everyone but the drug companies can entertain alternatives. The only group that stands to lose from a more responsible use of antibiotics is the drug companies."

A bill introduced in Congress in 2007, the Preservation of Antibiotics for Medical Treatment Act, was one attempt to address these issues. Sponsored by Rep. Louise Slaughter, D-N.Y., the only microbiologist in Congress, and Senate Health Committee Chairman Edward Kennedy, D-Mass., the bill would have withdrawn approvals for feed-additive use of seven classes of antibiotics of value to human medicine and required producers of agricultural antibiotics to provide data to public health officials on the usage of the drugs they sell.

The costs associated with continuing industrial farm animal production are enormous. If it's allowed to continue, industrial production as currently practiced could eventually eliminate a lot of other farming
options (in addition to making a lot of us sick). As one Midwestern organic farmer explained to me, it's simply not possible to raise pigs organically if you live too close to a confinement facility: The pathogen pressure is too intense. "Iowa has become a sink for pig diseases," he said. "They're just in the air, and you can't avoid them."

Five Nasty Microbes Linked to Factory Farming

Campylobacter: This is the most common cause of foodborne diarrheal illness in the United States, causing an estimated 2 million cases each year. Most don't require medical treatment, but a small number
(approximately 50 per year) end in death. Chicken and turkey are the usual sources: Studies have shown that most conventional chicken is contaminated when it leaves the processing plant. Rising numbers of Campylobacter infections resistant to a class of antibiotics called fluoroquinolones led the FDA, in 2000, to seek to ban fluoroquinolone use in U.S. poultry production. The ban was held up in court by drug maker Bayer, but was finally put in place in 2005.

MRSA: Staphylococcus aureus is a bacteria widely present in our environment and usually harmless, but in susceptible individuals it can cause life-threatening infections. Methicillin-resistant Staphylococcus
aureus, or MRSA (pronounced "mir-sah"), used to be primarily a problem in hospitals, but these days, cases of MRSA are increasingly likely to be "community-acquired," and evidence suggests that factory farms are a source. MRSA can be spread by human or animal carriers with no signs of illness; a recent study found that nearly half of Dutch pig farmers, and 39 percent of pigs in Dutch slaughterhouses, were carriers of MRSA.

Salmonella: This is another bacteria causing frequent and sometimes serious foodborne illness, with an estimated 1.4 million U.S. cases each year, including 18,000 hospitalizations and 600 deaths. Salmonella can contaminate beef, poultry, eggs and even vegetables. Antibiotic-resistant Salmonella is on the rise: One strain, known as DT104, is resistant to five major antibiotics used in humans.

E. coli O157:H7: Most Escherichia coli bacteria are harmless, but a few strains, including the notorious O157:H7, can be deadly. Ground beef is the most common contaminated food source for people, but as the spinach scare of 2006 showed, other foods can also be affected. The toxic strains are linked to conditions in beef feedlots.

Enterococci are a widespread group of intestinal bacteria that can cause serious infections in other parts of the body. Antibiotic resistance is a major concern with Enterococcus faecium, the strain most commonly associated with illness in people. In Europe, vancomycin-resistant Enterococcus (VRE) is a widespread environmental contaminant, where its emergence has been linked to agricultural use of avoparcin, an antibiotic closely related to vancomycin. In the United States, VRE is more often found in hospitals, and doctors are running out of treatment options: About 4 percent of VRE patients no longer respond to the antibiotic Synercid, a last-defense drug which is unfortunately related to virginiamycin, widely used in U.S. animal agriculture.

What You Can Do

Reduce the amount of meat in your diet. Industrial farm animal production is driven by rising global demand for meat. Healthy protein alternatives include whole grains, beans, nuts and dairy products. Think of meat more as a seasoning (as in soups and stews), not an essential, three-meals-a-day main course.

When you do eat meat, buy from local farmers practicing humane, sustainable methods. Seek out meat and dairy products labeled as "raised without antibiotics," and tell your local market manager you'd like to see more such products on store shelves.

Contact your Congressional delegation and ask them to support legislation to limit antibiotics in livestock feed, such as the Preservation of Antibiotics for Medical Treatment Act, introduced to Congress in 2007.

[Oscar]

Antibiotic use in livestock questioned

PUBLIC HEALTH

http://www.theglobeandmail.com/servlet/ ... y/National

Little oversight of loophole that allows farmers to import medications, article says

MARTIN MITTELSTAEDT April 11, 2009 ENVIRONMENT REPORTER

Canadian farmers may be putting public health at risk through the widespread practice of importing unapproved and untested antibiotics for use in livestock, the Canadian Medical Association Journal says.

In an article released online this week, the journal says a loophole in federal law allows meat producers to import about $100-million worth of medications into Canada each year with little oversight.

Farmers often give antibiotics and other drugs to healthy animals to hasten their growth or prevent disease outbreaks, but medicating healthy livestock is considered controversial. The European Union banned the use of antibiotics as growth promoters three years ago, in part because many medical experts say the practice provides an ideal environment for breeding drug-resistant superbacteria.

People could pick up such bacteria either from undercooked meat, or from the general environment through the dispersal of manure and other farm wastes. Farmers limit direct human exposure to drug residues by not using medications for a period before animals are slaughtered.
The journal is highlighting the issue because a federal task force dominated by the livestock industry raised the prospect of having Health Canada keep in place the import loophole for another two years, while the government studies a pilot program for placing limited restrictions on such drug purchases.

The little-known drug issue has been simmering since 2002, when an advisory committee to Health Canada urged the government to tighten the loophole by preventing farmers from importing antimicrobials not evaluated and registered for use here.

Farmers are able to import drugs under Health Canada's so-called "own use" policy that allows individuals to bring up to a 90-day supply of most drugs into the country for personal consumption. The policy has been broadly interpreted as allowing farmers to import drugs for their animals.

A report and recommendations from the task force were published with little fanfare on Health Canada's website on Dec. 30, and was open for a nine-week consultation period. But a link to the report wasn't operational for five weeks, and started working only after the CMAJ inquired about it.

In a statement, Health Canada said it considers the problem of antimicrobial resistance a "priority." But it cautioned that antibiotic use "in both humans and animals contributes greatly towards public health," while also raising the potential of antimicrobial resistance. "There are ongoing debates with respect to the contribution of agricultural use of these drugs towards the global burden of antimicrobial resistance in humans," it said.

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