China: A Looming Antibiotic Resistance Problem

And you thought fixing the renminbi was bad. By way of Glyn Moody, we find that The Guardian has a very disturbing report about antibiotic resistance in China (italics mine):

Chinese doctors routinely hand out multiple doses of antibiotics for simple maladies like the sore throats and the country's farmers excessive dependence on the drugs has tainted the food chain.

Studies in China show a "frightening" increase in antibiotic-resistant bacteria such as staphylococcus aureus bacteria, also know as MRSA . There are warnings that new strains of antibiotic-resistant bugs will spread quickly through international air travel and internation food sourcing.

"We have a lot of data from Chinese hospitals and it shows a very frightening picture of high-level antibiotic resistance," said Dr Andreas Heddini of the Swedish Institute for Infectious Disease Control.

"Doctors are daily finding there is nothing they can do, even third and fourth-line antibiotics are not working....

Particular alarm has been raised by resistance rates of MRSA in Chinese hospitals, which has more than doubled from 30 per cent to 70 per cent, according to Professor Xiao Yonghong of the Institute of Clinical Pharmacology at Beijing University.

Last year researchers found a new strain of MRSA in Chinese pigs imported into Hong Kong and called for urgent new studies into its potential to infect humans after an infection of the new strain was confirmed in Guangzhou, where many of the pigs were farmed.

A Beijing-based health expert with access to unpublished surveys showed that the situation in China was actually worse [than] earlier studies had indicated.

"The Chinese Ministry of Health has all the data," the expert warned, "but they seem unable or unwilling to believe it. The situation has global implications and is highly disturbing."

And enforcement efforts by the Chinese government seem about as effective as copyright enforcement (italics mine):

China's State Food and Drug Administration bans the sale of antibiotics without prescription but a survey by the The Daily Telegraph found the drugs were still easily obtainable over-the-counter.

Three out of five chemists agreed to sell antibiotics after a cursory consultation with the 'patient' who complained of a sore throat.

At one outlet a pharmacist handed over a course of the second-generation antibiotic, Cefuroxime Axetil, with minimal hesitation.

Asked if the sale could "get her into trouble" she said that the pharmacy would get a doctor to write the prescription later to cover their sales records. She added that even doctors from the nearby Capital Institute of Pediatrics came to buy antibiotics without prescription.

"When the surveillance is strict, we won't risk selling antibiotics," Ms Zhang added. Asked to elaborate, she explained, "For example during the 2008 Olympic Games period, we didn't sell them".

In fairness, the MRSA frequency isn't that much higher than reported in U.S. hospitals, although it is about ten times higher (or greater) than countries where MRSA is kept in check. On the other hand, talking with some Boston-area infectious disease specialists, when they find an atypical multi-drug resistant bacterium, the leg work traces the bacterium back to a potential Chinese origin, at much higher frequency than one would expect (we don't want no foreign multi-drug resistant bacteria, only those that evolved right here in the U.S. of A., pal!).

And, as the case with all epidemics, they do start with one case*...