Foodborne illness resulting from organisms that are resistant to antibiotics is an emerging problem and a facet of a much greater challenge that threatens the health and safety of entire populations.
As a result of the threat from Antimicrobial Resistance (AMR), the U.S. Department of Health and Human Services (HHS) and the European Commission formed the Transatlantic Taskforce on Antimicrobial Resistance (TATFAR) and recently issued a report outlining the problems posed by AMR and the goals of the Taskforce intended to address them.
Antimicrobial agents, including even the newest and most powerful drugs will, over time, be rendered ineffective, according to the report, “by the remarkable ability of bacteria to become resistant through mutation or acquisition of resistance genes from other organisms. When an antimicrobial drug is used, the selective pressure exerted by the drug favors the growth of organisms that are resistant to the drug’s action. The extensive use of antimicrobial drugs has resulted in drug resistance that threatens to undermine the tremendous life-saving power of these drugs.”
The magnitude of the resulting public health challenge is summarized in the report as follows:
“Antimicrobial Resistance (AMR) is a public health problem of increasing magnitude and importance recognized by the United States (US) and the European Union (EU), as well as their partner countries. Resistance occurs naturally, but misuse and overuse is rapidly increasing the prevalence of hard to treat infections in both humans and animals. At the current pace AMR is developing and given the lack of new antimicrobial drugs in development, we could foresee a future in which our grandchildren may once again begin to die from complications of a mundane infection from a skinned knee or in which patients no longer consistently survive routine surgeries.
“The societal and financial costs of treating antimicrobial-resistant infections place a significant burden on society—a burden that is likely to grow as the number of drug-resistant infections increases. Patients infected with drug-resistant organisms are more likely to remain in the hospital for a longer period of time and to have a poor prognosis. Furthermore, infections caused by drug-resistant organisms have a financial burden because of increased costs associated with additional doctor visits, longer hospital stays, more expensive drugs and treatment options, and productivity losses.
“One of the primary causes of AMR is the widespread and indiscriminate use of antibiotic agents in animals used to produce human food. Again, the report notes:
“In addition to their central role in human medicine, antimicrobial drugs have been used extensively in livestock and poultry since their discovery for the treatment, control, and prevention of animal diseases, as well as for production purposes in some regions (e.g., to enhance growth, improve feed efficiency). In contrast to human medicine in which treatment is usually directed toward an individual patient, entire groups of animals may be treated by the use of medicated feed and water. As a result of continued exposure to antimicrobial drugs, the prevalence of resistant bacteria in the faecal flora of food animals may be relatively high. Determining the impact of these resistant bacteria on human infections is an ongoing challenge as many classes of antimicrobial drugs used in food-producing animals have analogues to human therapeutics and are, therefore, capable of selecting for similar resistance phenotypes. Of note, a number of these antimicrobial agents are also used in companion animal medicine and aquaculture (seafood production).”
Use of antibiotics in animals along with improper use in humans (e.g. prescribing antibiotics for viral conditions or using broad-spectrum antibiotics for conditions that are amenable to treatment with narrow-spectrum antimicrobials) contributes to an astonishing statistic cited in the report: “Nearly 50% of antimicrobial use is unnecessary, inappropriate, or not optimally effective as prescribed.”
In the context of foodborne illness, we are already seeing the emergence of more virulent and antibiotic resistant pathogens. This certainly stands to reason if the animals that harbor them are and continue to be fed prophylactic doses of drugs in large-scale, industrial-type animal production.
In some respect, AMR is not unlike climate change: a well-documented and dangerous phenomenon that will become worse over time through a process that is all but invisible and not yet fully understood. And like climate change, regulation of AMR is opposed by powerful interests (i.e. drug companies, agricultural interests and food processors) that face economic uncertainty if the status quo is changed.
Stay tuned.
” Resistance occurs naturally, but misuse and overuse is rapidly increasing the prevalence of hard to treat infections in both humans and animals.” This is getting really scary, and we are seeing so many invasions on many fronts like in you article on flies spreading it from cattle to humans.
I know, it is really scary. I hope beyond hope we don’t go back to a time when an ordinary cut can kill because the antibiotics won’t work.