Animal Antibiotics Threaten Public Health-Time Magazine

Animal Antibiotics Threaten
Public Health-Time Magazine

Time Magazine

Playing Chicken With Our Antibiotics
Overtreatment is creating dangerously resistant germs
BY CHRISTINE GORMAN

Monday, Jan. 21, 2002

It's the sort of thing any good poultry farmer notices right away: a few of
the birds in a so-called grow-out building have started snickering--the
chicken equivalent of coughing. A respiratory infection, if that's what
they have, could spread to the 20,000 other birds in the chicken house in a
matter of days. The vet recommends the antibiotic enrofloxacin--the animal
version of Cipro. Since it's not practical to treat the birds individually,
the farmer pours a 5-gal. jug of the drug into the flock's drinking water.
Five days later the birds are doing fine. Disaster has been averted.

Or has it? While enrofloxacin kills the type of bacteria that sickened the
chickens, it doesn't quite eliminate a different strain, called
Campylobacter, that lives in the intestine. The surviving germs, which
don't cause any poultry diseases, quickly multiply and spread the genes
that helped them fend off the antibiotic. Six weeks later, when the
broilers are carved up at the slaughterhouse, resistant bacteria spill out
everywhere. Even with the best sanitary controls, some campylobacter is
shrink-wrapped along with the thighs, breasts and drumsticks that are
delivered to your kitchen counter.

That's where the real trouble begins. Campylobacter is a major cause of
food poisoning in humans. Less than diligent hand washing or improperly
cooked meat could park you on the toilet for the next few days. And if
you're sick enough to need medical treatment, you might be out of luck.
Chicken Cipro is so closely related to human Cipro that any germ that has
become resistant to the animal drug can shrug off the human one just as
easily. Before 1996, when enrofloxacin was approved in the U.S. for use in
poultry, the number of Campylobacter infections in people that were
resistant to Cipro and its chemical cousins was negligible. By 1999, it had
jumped to 18%--a clear sign, many researchers argue, that at least part of
the increase is directly tied to the use of antibiotics on poultry farms.

Welcome to the harrowing world of antibiotic resistance, where drugs that
once conquered everything from pneumonia to tuberculosis are rapidly losing
their punch. Chicken Cipro is only the latest example of how humans are
burning their pharmacological bridges. Feed-lot operators are dosing their
livestock with antibiotics to keep them healthy under stressful growing
conditions. Parents are demanding the most powerful broad-spectrum
agents--often by brand name--for their children's upper-respiratory
infections. Consumers are snapping up cutting boards, dishwashing soap and
baby toys laced with antibacterial compounds, hoping to make their homes
perfectly sterile and safe.

Doctors have long understood that the indiscriminate use of antibiotics
usually backfires, selecting for germs that are tough to kill. But no one
was prepared for how easily resistance could spread even when the drugs
were used in what was thought of as appropriate treatment.

The problem is that bacteria share genetic information much more readily
than anyone thought. Individual cells--often from different
species--routinely exchange tiny loops of DNA called plasmids. They will
even pick up snippets of DNA from dead bacteria or viruses. Once a strain
of bacteria survives destruction by antibiotics, chances are it will
eventually pass on the genes for resistance to other germs. "It's a numbers
game," says Dr. Stuart Levy, a Tufts researcher and author of The
Antibiotic Paradox. And because they live everywhere and reproduce quickly,
bacteria have the upper hand.

It doesn't help matters that many Americans have come to think of
antibiotics as tools for prevention. Patients will often ask for the drugs
to keep their colds from turning into sinus infections, even though
antibiotics have no effect on the viruses that cause colds in the first
place.

What's harder to evaluate is the treatment of something like a middle-ear
infection, which is indeed caused by several different types of bacteria,
including Pneumococcus. Left alone, a handful of these infections could
lead to permanent hearing loss. And yet their treatment has, in just the
past 10 years in the U.S., boosted the prevalence of penicillin-resistant
pneumococci to more than 20%.

No one yet advocates allowing all bacterial infections to run their course.
But don't be surprised if your doctor takes more of a wait-and-see approach
with your next case of flu (which, like a cold, is caused by viruses).
Hospitals are also learning how to vary the drugs they give their patients
to diminish the chances of selecting for ever more resistant germs.

Relief may soon be on the way. Thanks to advances in the new science of
genomics, researchers have started to scour bacterial DNA for new and
possibly better targets for drug development. The goal is to produce a
compound that works so differently from today's antibiotics that germs
won't know how to start developing resistance. Other research has produced
drugs that help restore penicillin's ability to clobber resistant germs,
provided the compounds are given in combination.

In the meantime, the FDA is so concerned about the possibility of losing
Cipro and similar drugs that it has asked pharmaceutical companies to stop
selling them to poultry farmers. Bayer, which manufactures both Cipro and
enrofloxacin, is contesting the idea, arguing that resistance levels have
stabilized and can be managed.

The question remains: How much resistance are you willing to live with?
"Most infections you get that are drug resistant came to you drug
resistant," Levy says. You can do your part to halt their spread by not
taking antibiotics unnecessarily and following a doctor's orders when they
are prescribed. Saving pills for later, so you don't have to get a new
prescription, is definitely a bad idea. "We'll be in this business for a
long time to come," says Dr. Stephen Lory, professor of microbiology and
molecular genetics at Harvard Medical School. "We will come up with
something; bacteria will become resistant. We'll come up with something
new." It's the kind of contest where no matter how hard you fight, the best
you can hope for is a draw.

Reported by David Bjerklie and Alice Park/New York

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Hands Too Clean?
If the widespread use of antibiotics is helping drug-resistant germs
spread, will things get even worse if everybody starts using those new
antibacterial soaps? No one knows for sure, but there is cause for concern.
Unlike antibiotics, which are either found in nature or mimic the action of
natural substances, antibacterial soaps contain triclosan and other
synthetic chemicals that manufacturers once claimed could wipe out all
bacteria. But in the past two years, researchers have shown that some germs
can, at least in the laboratory, mutate to counter triclosan's effects.
That could be a problem because so many household products--from sponges to
cutting boards to dishwashing liquids--now contain triclosan. Once a few
germs develop resistance, they will be much more likely to survive in a
world full of triclosan. Many researchers believe that prudent consumers,
for their own good--not to mention the good of the planet--should keep
triclosan products out of the house.

What about alcohol-based sanitizers such as Purell? They are less likely to
pose a problem, because liquid alcohol quickly evaporates and leaves no
bug-fighting residue.


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