Category Archives: Viva!

We’re losing Antibiotics of Last Resort: NRDC’s Analysis Unveils the Global Spread of Drug Resistance

Carmen Cordova, Staff Scientist, San Francisco

Every week seemingly brings new evidence that we are overusing and on the verge of losing the effectiveness of life-saving antibiotics. The latest story to emerge was that discovery of a new form of bacterial resistance to colistin that can be easily shared between bacteria. Scarier still is that resistance to this critical antibiotic has spread globally.

Colistin is a drug of last resort which can save a patient’s life when faced with a multidrug resistant infection. The gene that gives bacteria resistance to colistin (“the colistin gene”), it turns out, is now more mobile and easily shared between bacteria, and has now been widely detected in meat, on animals and in people in many different countries.

What our new analysis maps, below, is that the list of countries across the world continues to grow, showing how this resistance gene has spread globally in food, animals and humans – from farms to communities, or vice versa.

Map of where mcr-1 (colistin resistance) has bee detected and associated categories of samples as of January 15th, 2016.png

What We Know

In November, Chinese scientists first published their discovery of the colistin gene (mcr-1) in bacteria in pigs in slaughterhouses, in pork (as well as in chicken) purchased from markets, and in human patients. Almost immediately, other scientists around the globe started checking for the colistin gene in their own collections of bacteria – i.e. bacteria that had already been collected from farm animals, meat, or human patients. In microbiology, as in life, you don’t always know what you’ve got until you specifically look for it.

Above is a map showing as of January 15th where the colistin gene has now been detected–in several countries and in all kinds of samples–from food animals, from meat, and from humans.

And because the colistin gene was detected more often in animals than in people, the authors of the original study say it is likely that this form of colistin resistance originated in animals and spread to people.

Here’s what we know:

  • The colistin gene has been found both hanging around in a healthy person’s gut, as well as in bacteria infecting especially vulnerable patients (children, elderly). That colistin gene has been detected in E. coli bacteria found in water, in a slaughterhouse, on workers (boot swabs) and on pigs, chicken, and cattle – on the animal and/or on the meat.
  • The bacteria carrying this gene (and resistance to colistin) don’t respect borders. They are moving across national boundaries either as passengers on international travelers, or in traded meat products.
  • Bacteria can collect resistance genes and splice them together on strands of DNA that can move around between bacteria. When a bacterium acquires one of these pieces of mobile DNA with many resistance genes, it can transform bacterium from one posing little threat to a potentially lethal superbug that resists treatment by multiple antibiotics.
  • One patient in Switzerland was infected with a multidrug–including colistin–resistant E. coli bacterium that could not be treated with almost any drugs of last resort. The bug had collected a ton of resistance genes along the way, including one for an antibiotic normally reserved for veterinary medicine, called florfenicol. This shows that bacteria that are infecting people are collecting resistance genes both from farms and from hospitals.

U.S. Outlook

We just don’t know if the colistin gene has showed up in the US. While colistin isn’t currently in use (as far as we can tell) in U.S. livestock production, other antibiotics in the same class are used. According to the FDA, they’ve tested almost 3,000 Salmonella bacteria for the gene and have come up with nothing.

Curiously, the FDA is not doing as much testing for this dangerous resistance as it could. The agency has only tested 76 of the E. coli bacteria in its collection despite the fact that the vast majority of colistin genes detected globally thus far has been detected in E. coli (although it’s also been found in some Salmonella and Klebsiella). Yet, we know that FDA has compiled samples of thousands of E. coli bacteria through their 12 years of grocery meat testing. FDA is mum about whether it will be testing for the colistin gene in those isolates.

To Stop the Spread, We Must Stop Overuse in Livestock Production

More than 70 percent of medically important antibiotics sold in the U.S. are sold for livestock– often for routine growth promotion and disease prevention in animals that are not sick. Leading medical experts, including the American Academy of Pediatrics and World Health Organization, warn that this practice causes bacteria to evolve and become resistant to the drugs we rely on them to treat them. And those drug-resistant superbugs can then spread to humans via the water we drink, the air we breathe, and the food we eat.

Two million Americans get sick from drug-resistant bacteria annually, and more than 23,000 die, according to conservative estimates.

While colistin itself is not used in livestock production here in the U.S., it is widely used abroad. And U.S. farmers commonly use other antibiotics that are often prescribed to treat the same illnesses as this drug of last resort–fueling resistance to other possible treatments that doctors would typically turn to first.

Several government reports last year called for reductions in antibiotic use, including in food animals. Most recently, a report from former Goldman Sachs economist Jim O’Neill, commissioned by the UK government, was issued.

That report calls out the critical need for nations to set numeric targets, to ensure that antibiotic use actually goes down. Admitting that there isn’t one silver bullet, the authors write that each country should be given the ability to identify their own way to meet that goal. In fact, we’ve seen this same strategy work in countries like the Netherlands and Denmark.

That’s not happening here in the U.S. While last year’s White House launch of a national strategy and action plan to Combat Antibiotic Resistant Bacteria garnered lots of attention, it failed to set any targets for reducing antibiotic use in livestock. That lies in stark contrast to clear goals on use reduction in human medicine. Perhaps it’s no surprise then that the latest federal report on antibiotic sales in livestock demonstrates continuous increases, up 23% since 2009 to 2014.

We should be moving forward, not backward. To get there, we need federal limits on the use of any antibiotic on animals that are not sick, regardless of the label attached to such use.

Our analysis provides a crystal clear example now of how antibiotic use in livestock and human medicine are intertwined and translate into a very real public health threat. We cannot afford to keep waiting for action–we need urgent action to curb unnecessary antibiotic use in animal agriculture to save our miracle drugs and the lives that depend on them.

switchboard_all?d=yIl2AUoC8zA switchboard_all?d=dnMXMwOfBR0 switchboard_all?d=bcOpcFrp8Mo

FAO calls on donors to support Syrian farmers in their hour of need

be29095663.jpg

With the war in Syria now approaching its sixth year, agricultural production has plummeted and food supplies are at an all-time low, pushing millions of people into hunger. FAO today called on governments to provide a boost in funding targeted at helping farmers keep their lands in production to prevent the situation from deteriorating even further.

New poll finds public is outraged by anti-choice laws once they learn about them

Regular readers of Feministing are well aware of the hundreds of state laws restricting abortion access that have been passed in the last several years—after all, we talk about it all all the time. 

But not everyone is. The brilliant thing about an incremental state-level anti-choice strategy is that it can be easy for the average person to miss. There’s been no blanket federal abortion ban that makes national headlines and provokes mass protests—just 318 state laws passed since 2010 that each, individually, made the procedure just a little harder to get but collectively make it all but impossible for millions of Americans in many states.

It’s not surprising then that much of the public has no idea just how many barriers to abortion care politicians have enacted lately. A new national poll commissioned by the National Institute for Reproductive Health (full disclosure: I used to work there) finds that less than half of voters are aware of this trend. But once they learn about it, they’re not happy about it. Nearly two thirds say these anti-choice laws are taking us in the wrong direction and huge majorities support policy proposals to, well, basically undo them: to ensure, above all, that abortion is regulated based on medical evidence, not politicians’ political beliefs.

Like a recent survey by Vox, the NIRH poll also found widespread agreement about what the abortion experience should be like: safe, legal, informed by accurate medical information, respectful, supportive, affordable, and without shame.

chart of responses to question about what abortion experience should be like

 

Only about one in five respondents said getting an abortion should be emotionally difficult, expensive, uncomfortable, embarrassing, or difficult in terms of travel or logistics. In other words, the vast majority of American voters—whether they identify as pro-choice or pro-life, whether they think abortion is morally wrong or not, whether they’d personally get one or wouldn’t dream of it—think abortion should be a positive experience for those who do chose it. Which makes them utterly out of step with the anti-choice extremists currently populating our state legislatures—a fact they may just not realize.

There’s hope that tide may be turning though. NIRH reports that the number of proactive pro-choice state bills, both proposed and enacted, more than doubled between 2014 and 2015. Last year, 76 of them passed in 31 states. And NIRH  is looking to make it even easier for advocates and lawmakers to go on the legislative offensive with a “playbook for abortion rights” that includes dozens of model bills to advance reproductive health and rights. It’s a page literally out of the anti-choice movement’s playbook: Americans United for Life’s model legislation has spread like wildfire throughout the states. If it’s been a winning strategy for an agenda only a vocal minority of Americans support, it’s past time for those of us with public opinion on our side to get in the game.

Enough is truly enough.

Governor Rick Snyder’s Flint, Michigan Water Poisoning Apology Tour

Your apology is NOT ACCEPTED, Governor Snyder.  OWN it, You’re responsible for the poisoning of Flint citizens. You can’t say you take full responsible for fixing something and not accept responsibility for CAUSING THE DISASTER.

untitled

image
A 6-year-old girl gets tested for levels of lead in her blood. A study found that the levels of lead in the blood of young children had more than doubled since this city switched its water source.

“A Man-Made Disaster”: The Flint Water Crisis In Photos

MUST READ

Flint, Michigan’s water crisis: What the national media got wrong
by Connor Coyne on January 20, 2016

Zika virus infection – Guyana, Barbados and Ecuador

Between 14 and 15 January 2016, the National IHR Focal Points (NFP) for Guyana, Barbados and Ecuador notified PAHO/WHO of cases of Zika virus infection.

On 14 January, the NFP for Guyana reported the first laboratory-confirmed case of locally-acquired Zika virus infection in the country. The case is a 27-year-old female from Berbice, Region 6, with onset of symptoms on 1 January.