Tag Archives: drug resistance

CBC analysis finds resistant bacteria in raw chicken

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Reporters from the CBC’s “Marketplace” program visited supermarkets in Canada’s three largest cities, bought 100 samples of chicken, and sent them off to a lab for analysis. When the analysis came back, they weren’t particularly surprised to find that two-thirds of the samples were contaminated by bacteria – that’s the sort of thing you expect from raw chicken. What they didn’t expect was that every one of the bacteria strains present in those bits of raw chicken, purchased from major supermarkets and labeled with big-name brands, was resistant to at least one antibiotic. Some were resistant to as many as eight.

“This is the most worrisome study I’ve seen of its kind,” said Rick Smith, the head of Environmental Defence, a consumer advocacy group.

The culprits in this case of superbug proliferation will be all too familiar to regular Covering Health readers.

Doctors and scientists told Marketplace co-host Erica Johnson that chicken farmers are overusing antibiotics — routinely giving healthy flocks doses of amoxicillin, tetracycline, erythromycin and ceftiofur to prevent disease and to make the chickens grow bigger, faster.

The full CBC program is available for free online. The reporters have even shared a spreadsheet of their test results.

Rather on drug resistance, psychology and Norwegian fish farms

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Dan Rather Reports, HDnet’s investigative series, has devoted its latest episode to antibiotic overuse and the resistance it has created. A transcript of the hourlong program is available in PDF format. Rather focuses first on primary care physicians and upon understanding the psychological and economic pressure they’re under when they choose to prescribe antibiotics that might not be strictly necessary. When he talked to Dr. Rita Mangione-Smith of Seattle Children’s Hospital, she illustrated that those forces can and have overcome clinical good sense.

In the 1990s, it was really bad. Okay, there are a couple of studies that were done – that were published in the Journal of American Medical Association, in JAMA, that showed that if you looked at national level data, we were, you know, prescribing antibiotics in greater than 50 percent of outpatient visits for most children with colds. And antibiotics do nothing for colds.

Rather extends this focus on psychology to his investigation of antibiotic-averse Norway as well. Norway, as you have likely heard, has kept antibiotic use and resistance so low that even good old penicillin can be relied upon there to fight many bacterial infections. While others have focused on Norwegian central policy, Rather also considers how Norwegian mores and attitudes toward medical intervention have helped that country’s physicians resist the temptation to overprescribe antibiotics.

As Gunnar Simonsen, head of that country’s microbial resistance surveillance system, told Rather, “Many Norwegians will not like to take drugs unless strictly necessary. That’s not a kind of an official policy. That’s how we were brought up.” Simonson said the other pillar of his anti-resistance campaign was simply infection control – fewer bacterial infections means fewer opportunities to use antibiotics.

In addition to primary care physicians, Rather looks at that other great breeder of resistance: large-scale livestock feeding operations. Here, he contrasts the well-known American story to that of Norway, where antibiotic use in industrial fish farming was slashed 97 percent from 1994 to 2008. Over that same time, farmers say they actually increased fish survival rates by replacing the antibiotics with vaccines. Prevention instead of cure.

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Hospital infections on rise in Nev., reporters find

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

lasvegassun

Part two of Marshall Allen and Alex Richards’ Las Vegas Sun hospital investigation series “Do No Harm” takes on hospital-acquired infections. Even though no agency in the state tracks such things, the duo managed to find 2,010 instances of drug-resistant bugs in local hospitals between 2008 and 2009. That number included 647 instances of hospital-acquired MRSA.

In the story, the explain how they overcame industry resistance to dig up the data themselves:

No health agency tracks these cases. In fact, hospitals derailed proposed legislation in 2009 that would have required them to publicly report cases of MRSA in their facilities.

However, hospitals are required by law to submit to the state billing records based on each patient visit. The Sun obtained that information from 1999 to 2009 and analyzed the 2.9 million hospital billing records as part of its two-year investigation, “Do No Harm: Hospital Care in Las Vegas.”

Because of how the records are coded, the Sun was able to identify the number of infections by the two bacteria, and for the years 2008-09 further identify the cases in which the records say the patients acquired the bacteria while hospitalized.

While it’s hard to put their numbers in a national context because of widely varying methods of measurement and reporting, the duo can say that such infections jumped 34 percent from 2008 to 2009. Allen and Richards then establish two facts:

  1. Some institutions have developed ways to keep MRSA and friends under control.
  2. None of those institutions are in Las Vegas, where inspections show that hospitals could be doing a lot more.

Efforts to force Nevada hospitals to disclose MRSA cases withered under heavy industry opposition, though the legislature is now considering a watered-down version that would not public the MRSA rates of specific facilities.

It’s worth noting that the paper has published responses from readers who have plenty of their own hospital horror stories. The website includes their input both in text and through excerpts of some of the voicemails Allen has  received since the first part of the series was published. They are heart wrenching but serve as an excellent example of how reporters can involve readers in a project.

McKenna on A. baumanii, the latest resistant bug

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

On her Superbug blog, AHCJ board member Maryn McKenna works her explanatory magic on Acinetobacter baumanii, a drug-resistant bug whose profile (and incidence) is, in McKenna’s words, “rocketing.”

A. baumanii is a nasty bug, causing not just wound infections but pneumonia, urinary tract infections, meningitis and bacteremia. Even more nasty, it collects resistance factors like baseball cards, and is commonly resistant to at least 4 antibiotic classes.

To make the outlook even bleaker, the antibiotic development pipeline for A. baumanii‘s class of bacteria has dried up and only super-toxic colistin can take out the nastiest strains of the bacteria. It looks like A. baumanii, whose resistant strains have spread explosively in the past decade, has a particular knack for spreading resistance.

The only real hope for containing A. baumanii, McKenna writes, may be cooperation between all the different local institutions in the fragmented American medical system.

AP looks at drug resistance worldwide

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

The Associated Press has neatly wrapped up its wide-ranging look at drug resistance and the threat it poses to global health into a flash-based multimedia presentation. The presentation consists of stories, infographics, videos and a photo/audio slideshow.

The two videos explain drug-resistant strains of various infectious diseases. The first looks at the wide availability of powerful antibiotics without guidance or prescription, addresses the problem as it has emerged both in the United States and in locales like Mexico and the Philippines. The second, which is about the use of antibiotics in large-scale livestock operations, relies on just one source, Dr. Craig Rowles of Elite Pork Partnership.

The AP uses infographics to establish the spread and scope of the problem, relying heavily on various world maps. I particularly like the timeline that accompanies the malaria graphic (click “statistics” in the upper right, then “malaria”); it shows the span of time from when each malaria-fighting drug was introduced to the date at which a resistant strain emerged.

Finally, they drive the problem home with three strong anecdotes, including a Southeast Asian boy with drug-resistant malaria, a man fighting the drug-resistant tuberculosis that killed his HIV-positive partner, and a woman who lost an infant daughter to MRSA.

Stories in the series:

The package is accompanied by this video.