Food is a potential route for exposing humans to antimicrobial resistant organisms

Antibiotics in Farming. Risk to Human Health

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Antibiotic resistance is one of the world’s most pressing public health problems. Health experts agree that there is serious danger of losing some of the most precious drugs—antibiotics, a subgroup of a larger group of threatened agents known as antimicrobials. Some strains of tuberculosis, for example, are now resistant to all available antimicrobial drugs. Unfortunately, tuberculosis is not the only resistant microorganism on the public health horizon.

Illnesses that were once easily treatable with antibiotics are becoming more difficult to cure and more expensive to treat. Infections from common antibiotic-resistant foodborne bacteria, such as Salmonella, can cause more severe health outcomes than infections with bacteria that are not resistant to antibiotics. Use of antibiotics in farming promotes the evolution of this resistance. Most of the antibiotics consumed by humans are excreted and therefore passed into the environment. Disposal of unused or unwanted antibiotics is another concern and in less developed countries waste water is less likely to be treated with the result that antibiotics are released into the environment. Animal herds treated with antibiotics can develop bacteria resistant to the drugs, and pass this on to humans directly, through contact with farm workers, or through food.

Scientific expert bodies for more than two decades have concluded that there is a connection between antibiotic use in animals and the loss of effectiveness of these drugs in human medicine. Using antimicrobial medicines on farm animals is one of the leading causes of the rise of superbugs, resistant to all but the strongest antibiotics. Medical authorities warn that the antibiotics available to treat even relatively minor human diseases are running out because of the rapid rise of such resistance.

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Antimicrobial resistance poses a serious threat to the safety and quality of feed and food as well as food security and livelihoods. Unhealthy animals are no longer able to generate food products of acceptable safety and quality for human consumption. This also has an economic effect as hazardous feed and food reduce the livestock sector’s access to trade and increase public health risks.

All animals carry bacteria in their intestines. Giving antibiotics to animals will kill many bacteria, but resistant bacteria can survive and multiply. Food can get contaminated whether the bacteria are resistant to antibiotics or not. Unwanted antimicrobial residues may be present in products of animal origin and in animal waste resulting in contamination of soil and water. Most of the antimicrobials used in livestock are excreted and this can further contribute to the emergence and spread of antimicrobial resistance. Preventing food borne and other intestinal infections reduces both infections that can be treated effectively with an antibiotic and antibiotic-resistant infections.

The use of the strongest antibiotics, a last resort for the most deadly infections affecting humans, should be banned altogether in animals, the guidelines advise. This should apply, according to the WHO, even in cases where an illness has been diagnosed in a food-producing animal. This recommendation is likely to be unpopular with farmers, who could risk financial loss, but is crucial to protect human health, according to the WHO, because the use of such antibiotics in animals is leading to increased resistance even to last-resort medicines, to the despair of doctors.

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Some uses of antibiotics in livestock operations are a matter of animal health, other uses have an economic motive. Especially troubling is their use not to cure sick animals but to promote “feed efficiency,” that is, to increase the animal’s weight gain per unit of feed. These nontherapeutic uses translate into relatively cheap meat prices at the grocery store.

Numerous studies have demonstrated that routine use of antibiotics on the farm promotes drug-resistant superbugs in those facilities. The reason for this is that when you feed antibiotics to animals, the bacteria in and around the animals are exposed to the drug, and many of them die. But there are always some that the drug can’t kill, and those survive and proliferate. While not disputing these facts, the industry argues essentially that what happens on the farm stays on the farm. There may be some superbugs there, but they don’t affect people. There are two main routes, however, by which superbugs can leave the farm and infect humans. One is a direct route, in meat and poultry products, and the other is an indirect route through the environment.

The use of antimicrobials for growth promotion was banned throughout the EU in 2006, but still occurs globally. However, this ban has not led to a significant decrease in antibiotic consumption because, typically, compensatory increases in metaphylactic and prophylactic use have occurred.

Humans and other animals can acquire resistant pathogens and commensal organisms simply by ingesting them. Contaminated meat and other cross-contaminated foods cause millions of cases of gastrointestinal illnesses such as salmonellosis and campylobacteriosis each year. In such large operations, antibiotics are often delivered to animals in food and water over extended periods. Bacteria are constantly being exposed to the drugs and eliminated from the populations. It is hard to imagine how resistance would not develop under these circumstances. Indeed, industrial livestock systems are hog heaven for resistant bacteria. Many smaller scale farmers around the world are dependent upon antibiotics to supplement animal feed, and actions will be needed to support them to make this change which will affect their lives and livelihoods.

Cientific evidence demonstrates that overuse of antibiotics in animals can contribute to the emergence of antibiotic resistance. The volume of antibiotics used in animals is continuing to increase worldwide, driven by a growing demand for foods of animal origin, often produced through intensive animal husbandry.

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Food is a potential route for exposing humans to antimicrobial resistant organisms. Processes in food production, storage and preparation are important factors in the development and spread of antimicrobial resistance. Food contaminated with resistant organisms can result in human illness that does not respond to available treatments. Even antimicrobial resistant microorganisms that do not cause illness can serve as a reservoir of resistance traits that can be transmitted to pathogenic organisms present in foods or people. Good hygienic practices across the whole supply chain are required to control antimicrobial resistance. Sanitation and hygiene reduce microbial contamination of foods, which also lowers the numbers of antimicrobial resistant bacteria entering the food chain.

Good husbandry, biosecurity and hygiene on farms are very important in managing the development of antimicrobial resistance. Ensuring good hygiene and high standards on farms, reducing the density of animals and integrated disease control programmes, such as vaccination, can all minimise the occurrence of disease and avoid the need for antibiotic use.

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Strengthening the ability of state and local health departments to detect, respond to, and report antibiotic-resistant infections. Educating consumers and food workers about safe food handling and proper handwashing. Identifying groups with a greater chance of infection and educating them about how to reduce the likelihood of illness. Promoting the responsible use of antibiotics in animals as well as humans.

Increasing antimicrobial resistance is a global issue and intervention by governments will be required to effect change. Public opinion and consumer pressure could be significant factors in driving change, particularly at a national level.