Suppose US agribusiness food animals were being fed a poison that killed a few tens of thousands of Americans a year. Would we want them to stop? Maybe we weren't sure but had more than ample grounds for suspicion. Would we want scientists and the government to be looking into it and maybe even halting it until we had a clear answer? I would hope so. But that seems to be the situation with antibiotics and factory farming. Yesterday we posted about the discovery by Dutch scientists that methicillin resistant Stophylococcus aureus (MRSA) had a home and probably an origin in pigs and cattle in that country. Simultaneously there appeared a good article by Alex Koppelman in that puts the issue in a wider perspective:
Today, by most estimates, farming consumes many more antibiotics than human medicine does. No one, including government agencies, has definitive numbers, but in 2001, the Union of Concerned Scientists released a now widely accepted estimate suggesting that up to 84 percent of all antimicrobials (a slightly broader category that includes antibiotics) were being used in agriculture. Studies conducted in Europe -- and one just released in Canada, the leading exporter of pork to the United States -- suggest that farm animals are at the very least reservoirs for heretofore-unseen strains and that the animals are passing those strains on to their human caretakers. Here in the United States, however, scientists have yet to study the possibility that agriculture may be playing a role in the changing nature of MRSA -- even though the way we raise the food we eat may be making us sick. (Alex Koppelman, Salon)
Koppelman's excellent piece adds more evidence to the with the discovery of MRSA in Canadian pigs (Canada is the largest exporter of pork to the US).
The study's authors surveyed 285 pigs of three different age groups from 20 pig farms in southwest Ontario. Twenty-five percent of the pigs, they found, were colonized -- that is, carrying the bacteria, but not necessarily infected by it -- with MRSA. In all, 45 percent of the farms had at least one colonized pig, and 20 percent of the farmers themselves were colonized.
The story also mentions MRSA in pigs in Denmark (number two exporter of pork to the US) and chicken in Japan. Is profligate antibiotic use on the farm to blame for at last some MRSA? We don't know for sure. For sure? Well it's pretty plausible and MRSA aren't the only antibiotic resistant bugs linked to agri industry. How "sure" do we have to be?
But research money is now very tight and there has been a shift of funding away from the everyday killers like MRSA and TB and toward the hardly-ever-killers represented by the biodefense effort. It would be hard to get the train moving in any event. There are billions of dollars involved, US agribusiness is more powerful than the public health community (I am prone to understatement) and the industry is not eager to even cooperate, much less use their considerable political clout to advocate.
So was my initial question a real one or a rhetorical one? With this administration and the current Congress I'd have to say it was rhetorical. Maybe someday it will be a serious one. We can hope.
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Recently it's been show that bacteria that infect us can infiltrate plants and survive there, where they cannot be killed without killing the plant. So now we have to worry that virulent resistant strains, which are encouraged by feeding farm animals antibiotics, may also find their way to us through our food handling, and the eating of raw fruits and vegetables. No amount of washing or bleaching will kill bacteria residing inside the plant.
We have a similar problem in the hospitals. Doctors and nurses, whenever they feel a cold coming on, dose up on the latest and greatest antibiotics in order to not miss work by being sent home sick. Technicians and medical staff also practice this, and so do visiting police officers and firefighters. Paramedics and EMTs will befriend somebody at a hospital so that they too can get antibiotics. Nobody wants to waste their precious sick leave on being out sick.
This practice makes hospital workers and their regular visitors reservoirs for antibiotic-resistant strains. It's no wonder that MRSA and C difficile are showing up more often in more places.
To combat these problems we would need frequent urine testing of all those people for antibiotics, and abolishing the use of antibiotics in animal feed.
I've worked in a few hospitals as a nurse. I admit I haven't tried very hard, but on the rare occasions I've needed meds and haven't been able to make a trip to the doctor's office, I have never been able to get co-workers or friends to pony up prescriptions in U.S. hospitals where I've worked, much less to just hand over drugs. I know it's anecdotal, but my experience doesn't jibe with the unprescribed-abx-to-avoid-sick-leave scenario. Have there been studies suggesting this is a widespread practice?
Again anecdotally, I've seen a lot of scripts written without cultures for women with chronic urinary tract infections, kids with ear infections, and chronically ill elderly with fevers of unknown origin. However, given that the alternative is to make a sick and miserable patient wait for culture and typing (sometimes without a practical way to get at the bugs) before treatment, I'm pretty hesitant to call even that abuse.
Just wanted to add to the disussion that in Sweden antibiotics are not used preventively in animal production and that the relative frequency of MRSA among Swedish Staphylococci is also lower than what is found in other parts of Europe or in the USA for that sake. - While there may be no proved causal relationship between over-use of antibiotics in agriculure and the rise of resistant strains it is certainly tempting (and it seems very plausible) to belevie that there is one.
The executives of our giant food corporations love their customers and want to take care of us, by selling us healthy food. And they have a profound love for the animals they raise.
If you were a chicken or a pig you would obviously prefer to live in the living hell of a factory farm, instead of living outside where you could see the sky, grass, and other animals.
The pollution of our water supply by factory farms is actually good for us. Would you not prefer to consume water with chicken and pig feces in it, than consume clean water?
Corportate profit has absolutely nothing to do with it. These wonderful executives would even take a pay cut, it they thought it would help us.
The antibiotics fed to animals is good, because it will help to grow a superbug that not only eats human flesh, but is capable of killing millions, thereby reducing the human overpopulation problem.
Each day I praise our corporate executives for their infinite goodness. You should do the same.
Dear Revere,
I would like this discussion to evolve from blaming to information sharing.
I had experience with MRSA from Jan to April of this year with my father-in-law. Dad had surgery in January at a local hospital for repair of an aneurysm in the groin area. Within a week he developed an infection, was treated with drip antibiotics, and sent home with antibiotic Rx. Went back to the hospital for a fever, different antibiotic drip, sent home with new antibiotics. Went back for wound failing to close, wound pump applied, changed antibiotics, sent back home with new antibiotics, home care nurse called in. Wound goes putrid and bleeding, fever, sent back to hospital, wound pump removed, surgery to clean and flush wound, MRSA diagnosed, antibiotic drip, quarantine, masks, etc, 8 day stay in hospital, sent home with new antibiotics, AND OPEN WOUND, home care nurse can't continue to come because Medicare doesn't cover THEIR costs, trained me and his daughter to change dressings. Up to this point I have been with him 12 hours a day, his daughter on weekends and son sleeping at night with him. I presume we are all now colonized with MRSA.
Poor Dad suffered a lot with this, diarrhea with the different antibiotics, changed meds, tape stripping his skin during wound dressing changes 3 times a day. It was a mess, but he toughed it out and didn't complain. I have so much admiration for him.
As a cancer survivor, I just couldn't take a chance on contracting MRSA, so the daughter did two wound dressings and I handled laundry, bathing, cleaning the bathroom, etc. with gloves on. Home care nurse visited once a day. None of the care-givers contracted MRSA, so we were lucky and blessed. I learned more than I ever wanted to know about sterile technique.
Dad is fine as far as the infection goes, but now he is on dialysis and I worry about the port in his chest and the fistula becoming infected. He is 81 years old and could use a break. He is tired. He commented that ONE of the hospital stays cost over $70,000 billed to Medicare.
I don't doubt that he contracted the infection during the original surgery and hospital stay. I had no idea how mean MRSA could be.
I believe hospitals should change their liberal visiting rules to exclude children from the units and limit adults to a "need to know" basis--those people who are directly responsible for care when the patient goes home. I think MRSA is in that hospital to stay. MRSA could be deadly to children, and there are too many casual visitors in hospital waiting rooms and patient rooms.
Love,
Library Lady
Did you notice how the main "Scienceblogs" page covers this issue? They write there today:
> ultimately, it provokes the question of whether
> rampant antibiotic use in agribusiness may be
> worsening the problem of antibiotic resistance.
Like, DUH!
Who writes this stuff? Perhaps they can be helped?
Mt father was not as lucky as your FIL, Library Lady. He contracted a MRSA from the rehab center he went to after his knee replacement. He went from walking on his own to a body bag in three weeks.
I am glad your FIL made it through with the excellent care you all gave him. Unfortunately my father never made it out of the hospital.
Dear Gindy,
I am so sorry for your loss. I lost my dad to a blood clot after a 2nd by-pass surgery, about 12 years ago. He was up, walking around, eating well, and getting ready to go home, and then the blood clot hit. I still miss him. My father in law is a "pretty good Joe", and we're lucky he's still around. It's really hard losing parents.
I will pray for you and your family.
Love,
Library Lady
The key thing to act upon is the spreading of information. The United States, although a powerful entity, is not able to change itself completely (or in a minor sense if you think about it). Our government relies upon business and not the health or even word of the people. So, by spreading the word of these diseases and any relevant information can potentially be the stepping stone to change. It is great that we have some research of MRSA and its origins because this peaks peoples interest to learn more and research more.
I agree that the spreading of information would be the best way to tackle this issue. If more people were aware of animal meat as another origin of MRSA, as opposed to hospitals and long-term care facilities, maybe the demand for more intense food inspection and prohibition of antibiotic use on farm animals would increase.