I’m always loath to criticize mainstream discussions of the antibiotic resistance, particularly when the link between antibiotic use in agriculture and antibiotic resistance is raised. But, while NY Times columnist Nicholas Kristof meant well, he missed the mark.
In his column about MRSA ST398, he describes things that might happen. Here’s one example:
Public health experts worry that pigs could pass on the infection by direct contact with their handlers, through their wastes leaking into ground water (one study has already found antibiotic-resistant bacteria entering ground water from hog farms), or through their meat, though there has been no proven case of someone getting it from eating pork. Thorough cooking will kill the bacteria, but people often use the same knife to cut raw meat and then to chop vegetables. Or they plop a pork chop on a plate, cook it and then contaminate it by putting it back on the original plate.
The problem I have with Kristof’s column is that MRSA ST398 isn’t a hypothetical. The reason the spread of MRSA ST398 into the healthcare system scares the crap out of me isn’t that it might happen: it’s already happened. We already have documented evidence from the Netherlands, where ST398 has started to show up in the healthcare system in agricultural regions of the country. And in Sweden, ST398 is present in the community.
These are countries with reasonably good antibiotic use policies, so I’m not exactly optimistic.
I’m glad Kristof raised the issue, but the reflexive conservative denialists will attack the column, when he could have provided much stronger evidence. During my time dealing with the possible approval of cefquinome for use in agriculture, I ran into to pork lobbyists. If this issue gets serious attention, I expect to see conservative think tanks milking ‘sound science’ by getting contributions from pork lobbyists to host ‘impartial’ round tables and so forth. One of the tactics they’ll use is to downplay the ‘seriousness’ of the crisis. And Kristof didn’t help there.
An aside: The other gambit the ag lobbies will use is analogous to the smoking lobby: we don’t know for certain, blah, blah, blah. In the antibiotic resistance surveillance field, it’s known as ‘statistically sound sampling.’