Antibiotic resistance in food-poisoning bacteria on the rise

Bara Vaida

About Bara Vaida

Bara Vaida (@barav) is AHCJ's core topic leader on infectious diseases. An independent journalist, she has written extensively about health policy and infectious diseases. Her work has appeared in outlets that include the National Journal, Agence France-Presse, Bloomberg News, McClatchy News Service, MSNBC, NPR, Politico and The Washington Post.

Photo: NIH Image Gallery via FlickrSalmonella bacteria invade an immune cell.

A report released by the U.S. Food and Drug Administration showed that an increasing number of Americans infected with the foodborne pathogen, salmonella, are resistant to multiple antibiotics.

In 2015, multidrug resistance rose to 12 percent of salmonella cases, from 9 percent the year before, the FDA said. Eating raw or undercooked meat, poultry or egg products can cause salmonella infection. The bacterium also has been found on raw fruit – most recently on papayas from Mexico. The Centers for Disease Control and Infection says about 1 million of the estimated 48 million Americans sickened from a foodborne illness is caused by salmonella.

Many healthy people who are infected by salmonella don’t have any symptoms, but for some it can cause severe diarrhea, abdominal cramps and fever and lead to hospitalization. Overall, foodborne illnesses cause 128,000 hospitalizations annually and 3,000 deaths, the CDC says.

Resistant salmonella tracked by the FDA was found to be unresponsive to as many as four first-line antibiotics, a worrisome trend for public health officials. At least 2 million people in the U.S. contract an antibiotic-resistance bacterium annually and 23,000 die as a result. The threat has become so dire that the CDC announced that, for some patients, modern medicine had reached a “post-antibiotic” era. In September 2016, a Nevada woman died because she had become resistant to all approved antibiotics in the U.S.

Bacteria become resistant to antibiotics naturally. When an antibiotic is used, most bacteria are eliminated. A few resistant strains survive, however and continue to multiply and spread. For decades, pharmaceutical companies developed new antibiotics to keep ahead of resistance, but many companies stopped investing in new antibiotics. Antibiotic resistant bacteria, often described by those in public health as “superbugs,” are becoming more prevalent.

Public health leaders have been working on strategies for slowing the advance of superbugs. They are pushing physicians to stop overprescribing antibiotics and farmers to reduce the use of antibiotics in raising livestock. Though most people think of the use of antibiotics in people, antibiotics are more widely used in animals grown for food. The overuse of these drugs in agriculture is a key driver of antibiotic resistance.

The CDC declared the week of November 13-19 “Antibiotic Resistance Week” to raise public awareness around the issue of antibiotic resistance and appropriate prescribing of antibiotics. President Trump also pledged to implement the National Action Plan to Combat Antibiotic-Resistant Bacteria.

The plan, created under the Obama administration, includes efforts to reduce inappropriate antibiotic use in hospitals and clinical settings. About 30 percent of all antibiotic prescriptions are unnecessary, according to the CDC. The Food and Drug Administration also targeted the use of antibiotics in agriculture. The FDA issued a guidance ending the use of antibiotics in livestock for growth promotion.

For further reading on covering antibiotic resistance:

For more resources – see our new tip sheet on antibiotic resistance.

More questions? In December 2017, AHCJ will be hosting a webcast on antibiotic resistance with two officials from the CDC.

2 thoughts on “Antibiotic resistance in food-poisoning bacteria on the rise

  1. Lauren

    The current plan from the FDA is for drug companies to voluntarily opt-in to change their labels to require veterinarian approval.
    That is a good starting point, however that does not put the appropriate pressure on food production companies. In addition to the voluntary approach with the drug companies, the FDA should impose a financial penalty or tax on food companies who continue non-veterinarian use of drugs from companies that do not opt-in to the voluntary label change.
    This is important because it is possible that not all drug companies will opt-in, in which case all food production companies may choose to use whatever companies are left, instead of actively looking for ways to change. They will not be forced to stop the overuse of antibiotics in water and feed for food animals until the antibiotics are no longer so widely available.
    Food Safety News reported in August of this year that each year, over 400,000 Americans get sick from infections caused by antibiotic-resistant foodborne bacteria. Approximately one in five resistant infections are caused by bacteria from food and animals. With the direction the FDA is heading, I hope we can help reduce that number and start fighting back now.

  2. Zach

    The salmonella we’re dealing with today has the potential to wreak much more havoc than it did 20 years ago. It is disappointing that our own USDA Acting Chief Scientist has trivialized this public health crisis by calling into question the “low quality evidence” cited by the WHO in its latest guidelines to restrict antibiotic use on animals.

    Although the FDA and USDA have both released recommendations discouraging antibiotic use in the agricultural industry, the pace of these “collaborative” efforts have been slow. One commonly proposed solution is placing a tax on antibiotics sold for animal use. Could we not also slap on a requirement that any farm operation that chooses to continue antibiotic use must also demonstrate a specified percentage of reduction or a strategy to phase out antibiotic use, and if not, be subject to a hefty penalty?

    In addition, I think we can look to the success in the poultry sector, in which chicken farms such as Tyson are now completely antibiotic-free. As Big Chicken author Maryn McKenna explains, it was consumer demand that drove another major US chicken producer, Perdue Farms, to phase out antibiotic use.

    However, the problem won’t be solved merely by addressing the issues at home. The fact that around 44% of agricultural imports are horticultural products means that we need to ensure better stewardship around the globe, since other countries’ practices also influence our health risks.

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