Drug-resistant pathogens are a growing menace. The speed at which they’re emerging, and the size of the problem, constitute an urgent public health threat, says a federal interagency task force.
That ominous message is part of a draft action plan released for public comment this week by the co-chairs of the task force — the Centers for Disease Control and Prevention, Food and Drug Administration and National Institutes of Health.
“The extensive use of microbial drugs has resulted in drug resistance that threatens to reverse the medical advances of the last half century,” the report warns. Unless action is taken, “the world may soon be faced with previously treatable diseases that have again become untreatable.”
According to the task force, nearly all strains of Staphyloccus aureus in the U.S. are already resistant to penicillin and many are resistant to newer methicillin-related drugs. Even vancomycin, a recently reliable treatment, is no longer as effective.
“The public health burden of methicillin-resistant Staphylococcus aureus is staggering with over 90,000 invasive MRSA infections per year estimated in the U.S. population,” the report states.
Three years in the making, the 30-page draft, titled “A Public Health Action Plan to Combat Antimicrobial Resistance,” was published in the Federal Register Wednesday. It’s a broad overview of progress and proposals in the race to stop the threat of superbugs in hospitals, communities, farms and the food supply.
The draft plan is divided into four areas of focus: surveillance, prevention and control, research, and product development.
Of interest to food-safety advocates, some of the plan’s recommended goals include:
— promoting research and development of processing technologies to minimize microbial contamination of food, as well as alternatives to antibiotics used in animals
— developing alternatives to current processing treatments for reduction of E. coli in beef
— identifying processing interventions to decrease antimicrobial-resistant microorganisms in eggs
— evaluating the quantity of Clostridium difficile recovered from retail meats
— reporting regular summaries of antimicrobial resistance trends among foodborne pathogens on the National Antimicrobial Resistance Monitoring System (NARMS) website
Although the report draws on input received from all sorts of interest groups – agriculture, health care, pharmaceutical companies, consumer advocates, university researchers and others — reaching agreement on what needs to be done won’t be easy, the report’s authors acknowledge.
But the stakes are high.
Everything tried to date has not been sufficient, the report concludes, and coming up with solutions is going to take “a willingness to address complex and sometimes controversial science, medical and economic issues.”
One of those controversies, of course, involves whether antibiotics are being overused for food animals, and whether pig, poultry and cattle producers should end the common practice of adding daily antibiotics to animal feed, to prevent the spread of disease but also to accelerate growth.
Although livestock producers insist that antibiotic use in animals has not been definitively linked to antibiotic-resistant bacteria that can harm people, the task force report said there may be a threat to human health.
“As a result of continued exposure to antimicrobials, the prevalence of resistant bacteria in the fecal flora of food animals may be relatively high,” states the report. “Detemining the impact of these resistant bacteria on the management of human infections is an ongoing challenge as many classes of antimicrobials used in food-producing animals have analogues to human therapeutics and are therefore capable of selecting for similar resistance phenotypes.”
The draft report recommends identifying factors “important for assuring that antimicrobial drugs are used judiciously in veterinary, agriculture and aquaculture environments.”
U.S. Rep. Louise Slaughter, D-NY, longtime advocate for stricter regulations on antibiotic use in animals, called the draft report “welcome and long overdue” especially given new estimates that 80 percent of the antibiotics sold in the U.S. go to animals we eat.
In a news release, Slaughter repeated a call for passage of her “Preservation of Antibiotics in Medical Treatment Act” to address the overuse of antibiotics in agriculture.
“Antibiotics are used regularly and with little oversight in agriculture, and until we have effective limitations on antibiotic usage in agriculture, we will continue to battle rising antibiotic resistance,” she wrote. “When we go to the grocery store to pick up dinner, we should be able to buy our food without worrying that eating it will expose our family to potentially deadly bacteria that no longer response to our medical treatments.”
The action plan revises a previous one issued in 2001. The task force, created in 1999, was assigned to coordinate the work of all the federal agencies trying to address the problem of antibiotic resistance. In addition to the CDC, FDA and NIH, it included the Agency for Healthcare Research and Quality, the Centers for Medicare and Medicaid Services, the Health Resources and Services Administration, the Environmental Protection Agency and the departments of Agriculture, Defense and Veterans Affairs.
Comments on the report must be received on or before April 5, 2011.