MRSA Action UK: The rising threat from new superbugs
Thursday, 20 November 2008 12:00 AM
It has come as no surprise to MRSA Action UK of this week's report relating the first outbreak of a mutant strain of E.coli 026 on a dairy farm in the UK, and its relationship with the heavy use of antibiotics on farm animals. Antibiotics are probably the single most important discovery in the history of medicine. They were considered miracle drugs. Over the years they have saved millions of lives by killing bacteria that cause some of the worst infectious diseases in man and animals.
MRSA Action UK has serious concerns that whilst there is recognition that we can no longer have the ubiquitous use of antibiotics within our medical facilities, this same recognition has to be realised within the farming and veterinary community if we are to control the rise in resistance to our supply of antibiotics. History has shown that we ignore its lessons at our peril. We cannot afford to ignore the transfer of bacteria between animals and humans and the resultant consequences to health. Dealing with the ever present threat of antibiotic resistance has to be an "all or nothing affair".
The continuous ubiquitous use of antibiotics in animals is a misuse of a valuable resource in animal farming. There has been an ongoing debate since the 1960's on the use of antimicrobial agents in farm animals as a complex issue, with implications not only for the health of human's and animals, but also for animal welfare and food production systems and safety. Animal feeding practices have the potential to perpetuate the risks of resistance to antibiotics with waste products leeching into soil and water.
As far back as the mid-1960s there was growing concern over food borne infections especially with multi-drug-resistant salmonella and E.coli in the United Kingdom. It led the government of the day to establish an Independent Advisory Committee in 1968. The task of the Committee, which was chaired by Professor Michael Swann, was to examine the issue of transferable antimicrobial resistance and the consequences for human and animal health arising from the use of antibiotics in veterinary medicine.
The recommendations from the Swann Report were in fact based on less than full scientific certainty and created much debate and cries for more research. The report was faced with strong opposition from both the pharmaceutical and farming industries in the United Kingdom. The Swann Report gave us an early warning on the risk of antimicrobial resistance being spread amongst animals, and transfer to humans. Although the report was based on low level of scientific proof, it produced a competent microbiological assessment that did foresee possible adverse consequences of the continuous use of therapeutic antimicrobial agents in animal husbandry. The recommendations from the Swann report were clearly precautionary, although the word 'precaution' was not actually used in the Swann Report.
In the last few years substantial scientific evidence has shown that the use of antimicrobial agents in food animals contributes to the problems of antimicrobial resistance in humans. This has most convincingly been shown for vancomycin-resistant enterococci.
MRSA Action UK's grave concern is that subsequent scientific research, developed primarily during the 1990s, shows that transferable resistance is not restricted to certain bacteria, but is much more widespread within the microbes, and that resistant genes can easily move not only between closely related bacterial species, but also between unrelated bacterial species. The Swann Report was both accurate in its evaluation of the situation at the time, and far-sighted in its assessment of future trends.
The advisory Committee on the Microbiological Safety on Food (ACMSF) advised the UK government on food safety in 1999 that much of our modern medicine depends heavily upon the control of infection with antibiotics, and if this were to become largely ineffective it would have calamitous consequences for medical science, and also advised that giving antibiotics to animals results in the emergence of some resistant bacteria that will affect humans.
Today bacteria are evolving and mutating at an alarming rate due to the environment we are creating for them. The only method we have used in the past is to out-smart these bacteria in developing newer and more powerful antibiotics. Whilst the pharmaceutical companies have been eager to exploit this development and to press for the use of antibiotics in both human health and animal husbandry, they have in effect run out of the soft targets to develop newer antibiotics to combat these evolving bacteria. In effect the cupboard is now empty of any new antibiotics, we will have to preserve and use what we have more prudently.
MRSA Action UK is aware of the importance of the use of antibiotics in the rearing of livestock, and to the advantages that have been gained over the last 50 years of their use by the farming community. However the use of these miracle cures or the magic bullet to kill bacterial infections has within the last 70 years made previously fatal infections mere inconveniences.
If we lose the efficiency of the power of antibiotics, the effect to human health would be catastrophic, in that all of the advances in medical treatment such as transplants, cancer treatments, and heart by-pass operations would be consigned to the history books. The emergence of this new strain of E.coli 026 should be a wake up call to us all. Diseases that were once virtually wiped out are mutating and resisting antibiotics, we need to change the way we use these miracle drugs so that we do not throw away the legacy that Alexander Fleming gave us some 80 years ago.
Derek Butler
Chair
MRSA Action UK
07762 741114
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