Animal-Human Transimission of Dangerous Bugs Catches the Attention of Congress

"It remains unclear whether Congress will pass any of

the current legislation related to antibiotics in farm animals

this year.  But because of the increasing awareness of the 

issue, consumer demand for antibiotic-free meat is growing."

 

- Britt E. Erickson, Chemical and Engineering News (22 July 2013)

Antibiotics have been utilized in the rearing of livestock ever since industry discovered that they helped grow bigger, healthier animals during the antibiotic heydays post WWII.  The growth enhancing affect of the bactericidal compounds yielded larger quantities of meat and healthier animals, so who could blame mid twentieth century farmers for packing their feed supplies full of the new "miracle drugs"?  But, as the history of antibiotics has proven time and again, drug resistant bugs have been showing up in livestock ever since the practice started.  Agribusiness, government regulators, Congress, and lobbying groups have, not surprisingly, been arguing about this for decades, and have been getting nowhere... for decades.  In more recent history, as the threat of antibiotic resistance in the clinical and public heath setting has become ever more acute, consumer consciousness and government attention to the problem has been increasing.  Remember going to the grocery store during the 90's and picking out steaks and chicken breasts that were guaranteed "antibiotic free"?  Yeah, I don't either.  

Now, antibiotics are no longer the sole property of the scientific journals.  One is hard pressed to avoid coverage of the subject in all the major media outlets.  With the proviso that the coverage seems to be overwhelmingly geared towards scaring the hell out of everybody, it's refreshing to see the topic of antibiotic resistance and human microbiological ecology covered so widely.  One could argue that this broad, frequent coverage has helped spur meat suppliers to offer antibiotic-free choices at the meat counter.  Of course, the growing popularity of the organic food movement, localterianism, veganism, flexitarianism, foodieism, and the extraordinary success of "food TV", and ________ (insert other -ism I may have forgotten) has played a huge role too.  Whatever the motivation, the mounting concern over antibiotic use in livestock is reaching levels in which elected officials are actively proposing legislation to curb use and abuse of the 20th century miracle cures.  

As I was perusing the 22 July 2013 edition of Chemical & Engineering News, the American Chemical Society's weekly science news magazine, I came across a nice piece of reporting by Britt E. Erickson titled "Animal Antibiotics Under Scrutiny" (linked above).  Here, two recently published journal articles were highlighted that unambiguously documented animal-to-human transmission of drug resistant bacteria.  In an article in the journal PLoS One, J. L. Rinsky et. al. published the isolation of livestock-associated drug-resistant Staph from the noses of farm workers.  In a related article in EMBO Mol. Med., E. M. Harrison et. al. used genomic techniques to pin down a separate case of animal-to-human transmission of the infamous multidrug resistant S. aureus (MRSA), a scourge in hospitals and a benchmark bug for determining if a new antibiotic is worth developing.  These finding are important because they show that filling food animals full of antibiotics can generate antibiotic resistant strains (which we knew already) and that these strains can jump from the animals to their human handlers (an area where evidence was lacking).  Have you seen a zombie movie start this way?  Some kind of exotic bug jumps from an animal into a human, and boom, apocalypse city.  Sound familiar?  Should you really be concerned about the end of times?  No.  But will this give some fodder to those scientists, activists, and elected officials who feel that we need to be preserving our precious supply of antibiotics for treating human diseases?  It most certainly ought to, at the very least.

Indeed, there currently exists four bills to address this issue directly:

1. Preservation of Antibiotics for Medical Treatment Act (H.R. 1150); Rep. Louise Slaughter (D-NY) sponsor
2. Delivering Antimicrobial Transparency in Animals Act (H.R. 820); Rep. Henry Waxman (D-CA) sponsor
3. Preventing Antibiotic Resistance (PAR) Act (S. 1256); Sen. Diane Feinstein (D-CA) sponsor
4. Antimicrobial Data Collection Act (S. 895); Sen. Kirsten Gilllibrand (D-NY) sponsor

All of these bills would introduce new rules or regulations on the use of antibiotics in animal husbandry.  Some would serve to directly restrict the quantity, manner, and type of antibiotics that could be used in livestock (H.R. 1150, S. 1256).  Others would make the use of antibiotics much more transparent to the government and the public (H.R. 820, S. 895), as it is currently difficult to obtain detailed information from the FDA and livestock producers.  In all cases, the legislation would produce a stricter regulatory framework than  exists today.  Currently, the FDA works with farmers to spur the voluntary reduction of antibiotic use in feed stocks.  The thinking is not necessarily without merit, but many feel that the escalating drug resistance problem needs to be addressed quickly with regulatory measures that have "teeth".  Instead of telling livestock farmers that "we sure would like you to address this issue", it would be more, "you have to address this issue". 

It is easy to be pessimistic about anything getting done in Congress given the current political climate.  We can look to examples of legislation like the GAIN Act, which passed both houses in a bipartisan manner and was signed into law just over a year ago, as an example of both parties working together to solve an obvious problem.  But it's easy to argue that the agribusiness lobby will use its strength to bury the legislation highlighted here.  Wouldn't that feel more like "business as usual"?  Thus we come to the quote at the top of this post.  Wouldn't it be great if industry really did voluntarily reduce/eliminate the use of antibiotics because we (the consumer) would please like them to do that thank you very much?  If there's one thing that everyone in Washington loves, it's when the market solves a problem all by itself.  I'll remain hopeful, but you won't catch me holding my breath... unless I'm hanging out with MRSA infected farm animals.

- @EJDimise

New and Not-So-New Media Highlights

I'd like to recommend two interesting articles for your consideration and reading enjoyment.

Policies to Find New Drugs for Bad Bugs

The first is an article from the June 2nd New York Times titled, "Pressure Grows to Create Drugs for 'Superbugs'" by Barry Meier.  It highlights the growing urgency for the discovery and development of new antibiotics to treat drug resistant bacteria, a topic we've discussed here before.  Potential legislation, FDA rule changes, and new government subsidies for big pharma companies (GlaxoSmithKline is mentioned as an example where this is already in the works) are all floated as ways to streamline and incentivize the discovery, production, and marketing process for new drugs.  Here are a few snippets:

"The need for new antibiotics is so urgent, supporters of an overhaul say, that lengthy studies involving hundreds or thousands of patients should be waived in favor of directly testing such drugs in very sick patients"

"The overuse of antibiotics in people and animals, often for conditions for which the drugs are ineffective or not needed, is seen as a driving force in the development of resistant bacteria.  As these organisms have evolved and developed resistance, the development of new drugs has not kept pace."

Our Bugs, Ourselves - Current and Future State of the Human Microbiota

The second article is from the March 2013 issue of Nature Reviews Microbiology, which I somehow managed to miss until just a few days ago (my bad).  In a Perspectives piece titled, "The microbiome explored: recent insights and future challenges" - FYI this is not open access, so my apologies to those without full-text journal access - the journal interviews 5 prominent figures in the field regarding the current state and future directions of human microbiome/microbiota research.  We've touched on this subject several times here at Spent Media!  To give you a taste for the content of the discussion, here are some words from each of the featured scientists:

"The most important findings [regarding the human microbiota] to date are: the notion that we as humans are a superorganism, with our biology determined by the genes encoded in our DNA together with the genes of our microbial partners"

"... the current regulatory environment conspires against large-scale trials of prebiotics and probiotics for therapeutic purposes, and a more enlightened regulatory approach is necessary..."

- Dr. Claire Fraser, University of Maryland School of Medicince

"A very surprising finding has been that disruption of the homeostasis between the microbiota and the host, known as dysbiosis, has a more important role than host genetics in the development of a range of diseases, such as inflammatory bowel disease, obesity and type 2 diabetes."

- Dr. Jun Wang, Beijing Genomics Institute

"The human metagenome is orders of magnitude more manipulable than the human genome.  This difference provides the opportunities to intercede to prevent and treat illness, if only we knew what was important!  The use of faecal transplantation to treat colitis caused by Clostridium difficile seems to have at least some definite efficacy."

- Dr. Martin Blaser, New York University School of Medicine

"For formula-based nutrition supplements, we need to know more than simply the species composition of microbial communities; we need to understand how the communities function as ecosystems."

- Dr. Peer Bork, European Molecular Biology Laboratory, Heidelberg, Germany

"... characterizing the microbiota of divergent populations, including geographically and culturally isolated populations before they adopt elements of the Western lifestyle, may be crucial for understanding the suite of so-called Western diseases..."

"... we really lack the ecological and mechanistic understanding of the parameters that control composition and change in the microbiota to make it do our bidding."

- Dr. Rob Knight, University of Colorado at Boulder

[Notice the emphasis - again and again - on needing to gain a more complete understanding of our microbiota as an interconnected, complicated community functioning within a self-contained ecosystem - you.]

Happy reading!

- @EJDimise