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:
- Maryn McKenna, author of a new book “Big Chicken: The Incredible Story of How Antibiotics Created Modern Agriculture and Changed the Way the World Eats.” In a recent question and answer with AHCJ, she advises reporters find either a local farmer, a local advocate in the slow food movement, a local infectious disease physician or a vendor at a local farmer’s market and talk to them about how they are approaching antibiotic resistance.
- Reporters may also consider visiting a local public health laboratory that is working with the National Antimicrobial Resistance Monitoring System (NARMS), a joint federal effort to track resistance trends in people, food and food-producing animals.
- NARMS also collects data on local antibiotic resistance outbreaks, which can be mined for information about local antibiotic resistant outbreaks.
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.