# 5133
Yesterday Maryn McKenna wrote in her Superbug blog News break: FDA estimates US livestock get 29 million pounds of antibiotics per year.
If you haven’t already read it, you should. You should also check out today’s blog from Maryn, “Pig MRSA”: New human infections in France.
I’ll wait.
Today, a somewhat related correspondence appears in The Lancet on the rise of Ciprofloxacin-resistant campylobacterial infections in the UK. Cipro is a 2nd generation fluoroquinolone antibiotic.
The article (registration required for access):
Ciprofloxacin-resistant campylobacteriosis in the UK
Alison J Cody, Lorraine Clarke, Ian CJW Bowler, Kate E Dingle
The authors state that between 1995 and 2008, the percentage of campylobacter isolates cultured at the John Radcliffe Hospital, Oxford, UK that were cipro resistant has risen from 7% to 37.5%.
The incidence of erythromycin resistance, meanwhile, have remained basically unchanged at under 2.5%.
Although its use in poultry was banned in the United States in 2005, there are still about a half dozen fluoroquinolones authorized for veterinary use (cite NOAH) in the UK on cattle, pigs, chickens, turkeys, dogs, cats and other pet animals.
While normally individual animals are treated, entire flocks of turkeys and chickens may be treated with fluoroquinolones placed in their water supply for short periods of time under the direction of a licensed veterinarian.
The authors conclude that: government regulation of the poultry industry is necessary, since increasing numbers of ciprofloxacin-resistant isolates from human beings, most of which originate in poultry, imply a link to the veterinary use of fluoroquinolones
This article is actually a follow-up to a study printed last August The Lancet, called:
The growing UK epidemic of human campylobacteriosis
Original Text
Norval JC Strachan a, Ken J Forbes b
Campylobacter spp are the largest cause of bacterial gastroenteritis in the developed world. 1 The 2009 reporting rates for Scotland 2 and England/Wales 3 show more than 64 000 cases, representing year-on-year rises of 30% and 14%, respectively. Because there is substantial under-reporting, 4 the actual number of cases is likely to be closer to 450 000. Further, about 10% of reported cases are hospitalised. The sequelae of this disease not only include severe stomach cramps and diarrhoea but also, in up ...
Fortunately, although widespread (millions of cases are estimated each year in the United States) and misery inducing, campylobacteriosis is usually a self-limiting illness.
Only in severe cases are antibiotics required.
This from the CDC’s National Center for Zoonotic, Vector-Borne, and Enteric Diseases (NCZVED) factsheet.
What is campylobacteriosis?
Campylobacteriosis is an infectious disease caused by bacteria of the genus Campylobacter. Most people who become ill with campylobacteriosis get diarrhea, cramping, abdominal pain, and fever within two to five days after exposure to the organism. The diarrhea may be bloody and can be accompanied by nausea and vomiting. The illness typically lasts one week. Some infected persons do not have any symptoms. In persons with compromised immune systems, Campylobacter occasionally spreads to the bloodstream and causes a serious life-threatening infection.
How common is Campylobacter?
Campylobacter is one of the most common causes of diarrheal illness in the United States. The vast majority of cases occur as isolated, sporadic events, not as part of recognized outbreaks. Active surveillance through FoodNet indicates that about 13 cases are diagnosed each year for each 100,000 persons in the population. Many more cases go undiagnosed or unreported, and campylobacteriosis is estimated to affect over 2.4 million persons every year, or 0.8% of the population.
If most campylobacter infections don’t require antibiotic treatment, you may be wondering why regulating the use of fluoroquinolones in agriculture is looked upon as such a big deal?
Well, obviously, some people can become very ill and do require antibiotics when infected with campylobacter. More than 100 deaths a year are attributed to that bacteria in the US alone.
But, ciprofloxacin resistant campylobacter isn’t the only adverse result from using these types of antibiotics on livestock. It is just a fairly easily observed one.
Due to continued use (and frequently, misuse) around the world, other bacteria, like E. coli, C. Difficile and salmonella are also developing resistance to fluoroquinolones.
And these antibiotics end up in our food, and our environment, inviting even more bacterial resistance to develop.
Our victories over bacterial infections using modern antibiotics have rightfully been described as a miracle of modern science.
But improper stewardship of our dwindling arsenal of effective antimicrobial agents threatens to cripple our ability to treat many serious infections.
For more information on the prudent use of antibiotics, you may wish to revisit:
Eurosurveillance On Antimicrobial Resistance
