Maryn McKenna

Journalist and Author

Investigation: Drug Resistance, Chicken And 8 Million UTIs

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So, there’s this thing. A big project. An investigative project, actually. I’ve been working on it for months, and finally I can tell you about it, because it all just published, in various venues, today.

I’ve been working with a great new group, the Food and Environment Reporting Network — one of the grant-funded journalism organizations that have arisen in the wake of the collapse of mainstream journalism — on an important, under-reported topic. Which is: Over the past decade, a group of researchers in several countries have been uncovering links between the use of antibiotics in chicken production and the rising occurrence of resistance in one of the most common bacterial infections in the world.

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Food Trade Too Complex to Track Food Safety

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The data-dense graphic above may be too reduced to read (here’s the really big version), but its intricacy masks a simple and fairly dire message: The global trade in food has become so complex that we have almost lost the ability to trace the path of any food sold into the network. And, as a result, we are also about to lose the ability to track any contaminated food, or any product causing foodborne illness.

The graphic, and warning, come from a paper published last week in PLoS ONE by researchers from the United States, United Kingdom, Hungary and Romania. The group used United Nations food-trade data — along with some math that I do not pretend to understand — to describe an “international agro-food trade network” (IFTN) with seven countries at its center, but a dense web of connections with many others. Each of the seven countries, they find, trades with more than 77 percent of all the 207 countries on which the UN gathers information.

As a result, they say: “The IFTN has become a densely interwoven complex network, creating a perfect platform to spread potential contaminants with practically untraceable origins.”

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Bats, Booze, Bugs, Birds, Blood and Bushmeat (ICEID 4)

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Since I started electing to do blog coverage of scientific meetings, I’ve run into an unfortunate reality. On any meeting day, there are one or two presentations that either are strikingly newsworthy or fit into an ongoing topic that I’m already interested in, and that therefore I feel obliged to write about. That means I’m unable to cover dozens, sometimes hundreds, of other interesting papers and posters.

I feel bad about this, especially when authors stop what they are doing to talk to me. So here’s my admittedly insufficient remedy: a quick round-up of a few of the hundreds of intriguing presentations this past week at the biennial International Conference on Emerging Infectious Diseases. (Program here; it’s a pdf, abstracts not individually searchable.) Apologies to everyone whom I didn’t get to.

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Warm Weather Increases Hospital Infections, And What That Might Mean For Climate Change

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What makes hospital-acquired infections so intractable? There’s no question that some of the organisms that cause them are tricky: MRSA hangs out on the skin and and in the nostrils, and E. coli resides in the gut, making it easy for them to be carried into hospitals undetected. Hospital workers’ poor performance on hand-washing is well-documented. And recently, researchers have begun to wonder whether hospitals have missed an opportunity by not emphasizing environmental cleaning —- of rooms, computers and equipment, for instance -— given how persistently some bacteria can linger.

A new paper in PLoS One, though, says there’s another factor contributing to the problem, one that has missed consideration until now: weather. An 8-year study of infection data from 132 hospitals finds that as outside temperatures rise, in-hospital infections with some of the most problematic pathogens rise also.

The analysis is a warning to healthcare institutions to be additionally on guard when it is warm outside. But the authors say it’s also a warning to the rest of us: If global climate change raises ambient temperatures, it could increase the likelihood of deadly hospital infections as well.

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NDM-1 in India: Drug Resistance, Political Resistance

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It’s been more than a year since the “Indian superbug” NDM-1 — not actually a bacterium, but a gene that directs production of an enzyme — hit the news. The enzyme, whose acronym is short for New Delhi metallo-beta-lactamase-1, disables almost all antibiotics directed against it, leaving the bacteria in which the gene appears vulnerable to only two imperfect and sometimes toxic drugs.

The enzyme and its gene, blaNDM-1, were first identified in 2008 in people who had traveled in India or sought medical care in South Asia. Hence its name: Many beta-lactamases, enzymes that denature the very large class of everyday antibiotics known as beta-lactams, are named for countries and cities where they were first identified. Since its identification, NDM-1 has been discovered in patients in more than a dozen countries and has also been found to be widely harboured outside hospitals in India, and in surface waters and sewage there.

The unveiling of NDM-1 clearly caused embarrassment for India, and media and lawmakers there struck back, throwing around intemperate language and claiming the naming of the enzyme was a plot to derail the subcontinent’s medical-tourism industry — even though the Indian doctors had attempted to raise the alarm earlier and had been ignored.

So it seemed like a promising signal of openness when an international conference on antibiotic resistance opened in New Delhi a week ago. But in its wake, just what is going on in India — and whether its government is willing to face up to what might be an international crisis — is less clear than ever.

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Big News But: USDA Bans "Other" E. coli Strains

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Good news, but not excellent news, today from the US Department of Agriculture: It has agreed that, starting in March 2012, six more strains of E. coli will be considered “adulterants,” putting them in the same regulatory category as the much-feared E. coli O157:H7.

It is a big step, to do this. Those six bacterial bad actors — technically, E. coli O26, O45, O103, O111, O121, and O145 — are now responsible for the majority of foodborne illness caused by E.coli in the United States, causing almost twice as much illness each year as O157 does.

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Resistant Salmonella: Deadly Yet Somehow Not Illegal

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As the scale of the nationwide outbreak of Salmonella Heidelberg started to sink in Thursday — along with the stunningly large recall of 36 million pounds of ground turkey, much of it probably already eaten — there were a number of moments that made a careful listener need to stop and just think.

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E. coli: A Risk for 3 More Years From Who Knows Where

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The latest news from the European Centre for Disease Prevention and Control, the EU’s CDC, suggests that the massive outbreak of E. coli O104 is declining. The number of new cases being discovered has fallen, and the most recent onset of illness among confirmed cases was June 27. The  toll is now 752 cases of hemolytic uremic syndrome and an additional 3,016 cases of illness in 13 countries, for a total of 3,768 illnesses including 44 deaths. (The EU adjusted that total to remove 161 cases that were suspected but not lab-confirmed. It also did not include the five confirmed cases, one suspect case and one suspect death in the United States.)

But a simultaneous report from the European Food Safety Authority (EFSA) reveals that, despite the epidemic curve’s trending down, the outbreak can’t be considered over. The ultimate source — the contaminated seeds from which salad sprouts were grown — has been so widely distributed that no one really knows where they have gone or for how long they might remain for sale. One prediction, based on the probable package labeling, is that they could remain on shelves for three more years.

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Is Drug Resistance in Humans Coming From Chickens?

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There’s a new paper out in the CDC’s journal Emerging Infectious Diseases that makes a provocative claim: There is enough similarity between drug-resistance genes in  E. coli carried by chickens and  E. coli infecting humans that the chickens may be the source of it.

If it is correct — and it seems plausible and is backed by past research — the claim provides another piece of evidence that antibiotic use in agriculture has a direct effect on human health.

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