The Centers for Disease Control and Prevention released a report on Monday addressing and categorizing the threats of antibiotic resistance. Although it notes that the majority of drug-resistant infections occur in healthcare settings, concern is growing over antibiotic-resistant infections from food. Using various factors such as health impact, economic impact, 10-year projections and barriers to prevention, CDC grouped 18 resistant microorganisms into three threat levels of urgent, serious and concerning. Foodborne illnesses can be tied to six on the list: Clostridium difficile, Campylobacter, Salmonella, Salmonella Typhi, Shigella and Staphylococcus aureus. Antibiotics are commonly used to promote the growth of food-producing animals and to prevent, control and treat disease. But overuse can promote the prevalence of antibiotic-resistant bacteria in the food supply and ultimately cause resistant infections in humans. CDC estimates at least two million illnesses come from an antibiotic-resistant infection every year, and the Center for Science in the Public Interest (CSPI) reports that 22 percent of these are linked to the foodborne pathogens. About 80 percent of all antibiotics distributed in the U.S. were for food animals, and CSPI has documented 55 foodborne illness outbreaks between 1973 and 2011 where the bacteria identified were resistant to at least one antibiotic. Thirty-four of those outbreaks occurred since 2000. “Because of the link between antibiotic use in food-producing animals and the occurrence of antibiotic-resistant infections in humans, antibiotics should be used in food-producing animals only under veterinary oversight and only to manage and treat infectious diseases, not to promote growth,” reads the report. “We continue to promote the concept that, if an animal is sick, using antibiotics to treat that animal is obviously important,” said CDC Director Dr. Tom Frieden. “We also know that there are specific situations in which the widespread use of antimicrobials in agriculture has resulted in an increase in resistant infections in humans.” While the report states that CDC supports voluntary guidelines from the U.S. Food and Drug Administration for phasing out the use of antibiotics for animal growth, Dr. Michael Bell, deputy director of CDC’s Division of Healthcare Quality Promotion, noted that “when you think about where some of these bacteria are actually making people very sick, there’s an overlap in places like intensive care units, and so we continue to focus a great deal on healthcare settings.” The report provides a four-step action plan for generally fighting antibiotic resistance that includes preventing infections and the spread of resistance, tracking resistance patterns, improving our use of antibiotics and developing new antibiotics and resistance tests. But CSPI considers that the report “missed an opportunity” to give more advice in terms of food safety. “CDC has does a really excellent job with this report, both in reporting the hazards and giving really good advice to healthcare providers,” said Caroline Smith DeWaal, CSPI’s director of food safety, “but the agency was almost silent on what veterinarians or FDA and USDA could be doing to control pathogens coming through the food supply.” She says the report also contains good advice for what consumers can do to minimize their risk of contracting a foodborne illness, but it doesn’t address the role of producers. Based on CDC’s report, CSPI recommends that:
- FDA and the White House release new guidance for pharmaceutical companies, veterinarians and the food industry on the use of antibiotics
- Food producers use antibiotics on the advice of a veterinarian only to treat animal disease, and not as prophylactics or to promote growth
- Consumers buy meats with “USDA Certified Organic” or “Raised Without Antibiotics: USDA Process Certified” on the label to minimize their exposure to antibiotic-resistant pathogens in the meat supply.
U.S. Rep. Louise Slaughter (D-NY), who introduced the Preservation of Antibiotics for Medical Treatment Act in March and co-sponsored the Delivering Antimicrobial Transparency in Animals Act, which was introduced in February, is also using the CDC report as a call to action, stating her hope that it will prompt FDA to enforce regulation of antibiotics in food-producing animals.