Maryn McKenna

Journalist and Author

The Superbugs in Your Dinner (Bonus: Twitterchat!)

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I have a new story up at SELF Magazine, where I’m privileged to do a long and often investigative piece about once a year. This one is close to my heart: It took two years to complete, and in that time I conducted 37 interviews and reviewed several hundred scientific papers.

Here’s what it says: The misuse of antibiotics in agriculture, particularly in livestock-raising, is creating antibiotic-resistant foodborne illnesses that are taking victims and their doctors by surprise.

We talk pretty often here about drug-resistant bacteria arising as a result of farm antibiotic use, and moving off the farm in a variety of ways. There is a lot of dispute, of course, about whether farm-caused antibiotic resistance has much effect on human health, or whether the various resistant illnesses that people contract arise instead from antibiotic misuse in daily life or in hospitals and health care.

But in this case, the illnesses are being caused specifically by classic foodborne bugs that have become resistant and are making people sick when the food is handled or eaten. The evidence is not 100 percent — no evidence ever is — but to me, these illnesses demonstrate the most direct link yet between antibiotic use on farms, and human illness far away from farm areas.

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Court Scolds FDA Over Ag Antibiotic Use

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There’s been another development in the continuing court battle to get the US Food and Drug Administration to exert some control over agricultural use of growth-promoter antibiotics — and it arrives accompanied by some remarkably direct language from the US magistrate judge hearing the case.

In a Memorandum of Opinion and Order that was filed last Friday afternoon — which I extracted from the PACER system and stashed in my Scribd account — Judge Theodore Katz addresses the FDA’s denial of two citizens’ petitions regarding ag antibiotic use. I’ll explain the details below, but here is the key language:

… the Court finds the Agency’s denial of the Petitions to be arbitrary and capricious. For over thirty years, the Agency has been confronted with evidence of the human health risks associated with the widespread sub-therapeutic use of antibiotics in food-producing animals, and, despite a statutory mandate to ensure the safety of animal drugs, the Agency has done shockingly little to address these risks.

Whew. OK, the details:

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More On Court Ordering FDA Hearings on Farm Antibiotics

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Since I posted last night on the judge’s order that the Food and Drug Administration examine the safety of farm antibiotics — via hearings that the Food and Drug Administration scheduled, but never held, back in 1977 — a lot has happened. Here’s a round-up.

The Natural Resources Defense Council, lead plaintiffs in the suit (with the Center for Science in the Public Interest, Food Animal Concerns Trust, Public Citizen and Union of Concerned Scientists) has put up a press release/explainer, accompanied by a blog post written by lead attorney Avinash Kar.  (Correction: The lead attorney is Jen Sorenson.) Key quote from Kar:

The judge’s opinion makes it clear that FDA’s voluntary approach—letting the industry police itself—does not satisfy its legal obligations. FDA must schedule hearings to let drug manufacturers make their case, and if the drug manufacturers cannot prove that the use of antibiotics in animal feed is safe, FDA must withdraw approval for those drug uses.

Kar’s comment to me: “We think this is a great step forward for public health. For 35 years, FDA has basically sat on the sidelines, mostly letting the industry police itself. In that time we have seen a massive rise in the occurrence of antibiotic-resistant bacteria. This means we now will ensure that we preserve these lifesaving medicines for those who need them most.”

I asked the press office this morning at the Center for Veterinary Medicine, the FDA division named in the order, if the agency has a response yet. They said: “We are studying the opinion and considering appropriate next steps.”

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Breaking News: Judge Orders FDA to Examine Safety of Ag Drugs

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Here’s breaking news that I’ve learned about. The significance is going to unfold over the next 24 hours and more, and when it does, I will update. (Update: Overnight, a lot came out about this, so I’ve wrapped it all into a new post here.)

Here are the basics:

A district judge in New York has ruled in favor of a coalition that sued the Food and Drug Administration in order to compel the agency to follow through on its 35-year-old attempt to exert control over antibiotics in animal feed known as “growth promoters” — tiny doses of antibiotics delivered in feed and water that are believed to stimulate the evolution of antibiotic-resistant organisms.

Technically, Magistrate Judge Theodore H. Katz has granted the groups’ motion for summary judgement, and denied the FDA’s request that the suit be dismissed.

The decision, filed this afternoon, does not compel the FDA to ban growth-promoter (or “feed efficiency”) use of antibiotics. What it does appear to do, though, is require the FDA to follow through on a process that it began in 1977, when the agency was so concerned over the safety of using penicillin and tetracycline drugs in livestock feed that it called hearings to examine withdrawing its approval of using the drugs in animals.

Because of pressure, largely from certain Congressmen, those hearings were never held.

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High Levels of Resistant Bacteria on Meat (Again)

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A new report is out from the federal collaboration that monitors antibiotic resistance in animals, retail meat and people, and the news is not good.

The full title is the 2010 Retail Meat Report from the National Antimicrobial Resistance Monitoring System. This report is issued by the Food and Drug Administration; the humans one comes from the Centers for Disease Control and Prevention and the animals one from the US Department of Agriculture. It reports the results of testing on 5,280 meat samples collected in 2010 in California, Colorado, Connecticut, Georgia, Maryland, Minnesota, New Mexico, New York, Oregon, Tennessee, and Pennsylvania. (Those are sites of state labs participating in a federal surveillance network, FoodNet, plus one volunteer lab, Maryland.)

The report — which is broken down first by foodborne organism and then by meat type — notes a number of instances where either the percentage of bacteria that are antibiotic resistant, or the complexity of the resistance, is rising. Quoting from the report:

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Also Receiving Antibiotics on Factory Farms: Shrimp

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Tom Philpott of Mother Jones had a great post earlier this week looking at the vast environmental damage caused by shrimp farming in South and Southeast Asia. He takes off from a presentation at the annual meeting of the American Association for the Advancement of Science by J. Boone Kauffman of Oregon State University, which examined the destruction of coastal mangrove forests that allows shrimp farms to be established and found that shrimp’s carbon footprint is 10 times higher than that of beef cattle. Tom says:

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More News: FDA Curbs One Class of Farm Drugs

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Here’s a bookend to the Food and Drug Administration’s disappointing Christmas Eve notice that it will cease trying to regulate the largest classes of growth-promoter antibiotics. Today, the agency announced that it is forbidding certain uses of a different class of drugs, cephalosporins.

To those who are concerned about antibiotic overuse in agriculture, though, this is good news — though it may be more good news-bad news-bad news-good news.

The dialectic looks like this:

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FDA Documents Show Agency Once Strongly Opposed Farm Antibiotic Overuse

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The use of antibiotics and sulfonamide drugs, especially in growth promotant and subtherapeutic amounts, favors the selection and development of single and multiple antibiotic-resistant and R-plasmid-bearing bacteria.

Animals that have received either subtherapeutic and/or therapeutic amounts of antibiotic and sulfonamide drugs in feeds may serve as a reservoir of antibiotic resistant pathogens and non-pathogens. These reservoirs of pathogens can produce human infections.

The prevalence of multi-resistant R-plasmid-bearing pathogenic and nonpathogenic bacteria in animals has increased and has been related to the use of antibiotics and sulfonamide drugs.

Organisms resistant to antibacterial agents have been found on meat and meat products.

If you give the text above a close read, you might think it was written by Mark Bittman or Tom Philpott or Tom Laskawy, or me — or any of the small number of journalists who focus on the safety and policy perils of giving scarce antibiotics to confinement-raised farm animals. After all, what it says is what any of us would say: Routine administration of antibiotics to livestock spurs the emergence of drug-resistant bacteria that move through the food chain, threaten human health, and lend their DNA to yet other bacteria, increasing the reservoir of resistance in a dangerous and untracked manner.

As it happens, though, the text above wasn’t written by any of us. It was written by the Food and Drug Administration, the FDA.

Yes, the FDA — the federal agency that, as I wrote last Friday, has just backed off a 34-year attempt to assert regulatory control over “growth promoter” antibiotic use, opting instead for voluntary self-policing by the agricultural and pharmaceutical industries.

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News: FDA Won't Act Against Ag Antibiotic Use

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With no notice other than a holiday-eve posting in the Federal Register, the US Food and Drug Administration has reneged on its long-stated intention to compel large-scale agriculture to curb over-use of agricultural antibiotics, which it had planned to do by reversing its approval for putting penicillin and tetracyclines in feed.

How long-stated? The FDA first announced its intention to withdraw those approvals in 1977.

From the official posting:

The Food and Drug Administration (FDA or the Agency) is withdrawing two 1977 notices of opportunity for a hearing (NOOH), which proposed to withdraw certain approved uses of penicillin and tetracyclines intended for use in feeds for food-producing animals based in part on microbial food safety concerns.1 … (1FDA’s approval to withdraw the approved uses of the drugs was based on three statutory grounds: (1) The drugs are not shown to be safe (21 U.S.C. 360b(e)(1)(B)); (2) lack of substantial evidence of effectiveness (21 U.S.C. 360b(e)(1)(C)); and (3) failure to submit required reports (21 U.S.C. 360b(e)(2)(A)).)

There is a lot of background to this, but here is the takeaway: For 34 years, the FDA has been contending that administering small doses of antibiotics to healthy animals is an inappropriate use of increasingly scarce drugs — a position in which it is supported by organizations as mainstream as the American Medical Association. With this withdrawal, it backs away from the actions it took to support that assertion — which may indicate there will be no further government action on the issue until after the 2012 election.

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Fecal Transplants: They Work, the Regulations Don't

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Lara Thompson was 26 when her life fell apart.

She was living in Rhode Island and working in HIV prevention research when she unexpectedly developed nausea and diarrhea. It was early 2008, a few weeks after New Year’s, and she thought she might have picked up a stomach virus at a holiday gathering, or stressed her system with overindulgence. She expected the symptoms would pass after a few days. They didn’t.

“In three weeks, I dropped 15-20 pounds,” she says now. “I couldn’t keep anything in; I would have to run to the bathroom at a moment’s notice. I was so lethargic I had to stay home from work.”

When she consulted her doctor, she found out what was bothering her was more complex than a virus. Somehow, her intestinal lining had become infected with Clostridium difficile, or C. diff, a tough and persistent bacterium that has been rising in incidence and gaining antibiotic resistance, becoming increasingly difficult to treat.

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