Transcript Antibiotics Resistance - Institute for Environmental Policy

Antibiotics Resistance:
Impact and Alternatives
Endri Haxhiraj, MSc candidate
e-mail: [email protected]
The Problem
There is a growing concern that the use of antimicrobial drugs in veterinary
medicine and animal husbandry may compromise human health if resistant
bacteria develop in animals and are transferred to humans via the food
chain or the environment…
OIE (15)
The emergence and the spread of resistance to antimicrobials in bacteria
pose a threat to human and animal health and present a major financial
cost…
EFSA (2)
“The use of antimicrobials in animals is an important factor in the
development of resistance in some organisms, particularly those organisms
associated with food poisoning in man”
The UK’s Veterinary Medicine Directorate, 2010
Print media
Gazeta STANDARD
15 Gusht 2010
Pathogens resistant to antibiotics,
one of the most serious concerns for our
health
Print media
Gazeta Shqip
17 Gusht 2010
ALARM FOR:
“THE
UNDEFEATED
SUPER
BACTERIUM”
Facts
…there were 18,000 deaths (USA) in 2005 alone, that were caused by
antibiotic resistant Staphylococcus aureus infections, a number higher than
the number of HIV/AIDS related deaths.
Infectious Diseases Society of America
The use of Apovarcine as a promoter of growth in poultry selected for
enterococci that are resistant to all glikopeptids (a group of antibiotics).
Vankomicine is part of this group (antibiotic of last hope for some
diseases). The same clone of Vankomicine-resistant enterococci has been
found in animals and people (3).
NRC (3)
Actual situation
Anyone can go to a veterinary pharmacy and get every kind of antibiotics without
veterinary supervision or other measures.
Around half of the quantity of antibiotics produced in the world, is added in animals
feed (for farm animals) (13), with a large proportion of antibiotics being
administered in sub-therapeutic doses, not to treat diseases but to promote
growth (16).
Antibiotics given to animals via food or water can be dispersed through excretion,
thus increasing the bacterial resistance to antibiotics(3) and the number of the
resistant bacteria in the environment (9).
According to some studies, antibiotic resistance is regularly occurring in hospitals
(12).
How did it happen?
Sub-therapeutic doses of antibiotics are given to farm animals in
their food and water:
• To adapt to stressful environment;
• To promote rapid growth;
• To “control” the level of infection and diseases in farm animals;
• Because they are perceived as very
useful during intensive breeding or transport (3);
• Because it is considered to improve the farm’s performance when the
conditions are poor: i.e. when the animal is in poor health and the living
conditions are unhygienic (14).
Distortion of the normal bacterial flora and promotion of bacterial
resistance:
• Microbial pathogens suit (as in the case of resistance to antibiotics) to
new environmental conditions (5);
• Create a selective pressure on bacteria, causing the development of
resistance to antibiotics (6);
• Bacterial pathogens that survive in the internal organs of the animal, and
fed with extra antibiotics, are resistant strains (7).
How does it spread?
Possible ways antibiotics resistant bacteria can reach humans:
• Contaminated meat;
• Transfer of antibiotic resistant genes to other strains of
bacteria that infect humans;
• From humans infected with these strains (e.g., employees of
slaughterhouses, manufacturers and farmers) and;
• Indirectly through the environment (8) (e.g. passage of tetracycline
resistance genes from hog waste lagoons into groundwater wells)
(17).
Antibiotic resistance strains impact
When antibiotic-resistant bacteria reach humans or other animals :
• Treatment with the same antibiotic is useless;
• The infection is aggravated in elderly, children and individuals with
suppressed immunity;
• Choosing a suitable antibiotic can be difficult for some bacteria that are
resistant to more than one antibiotic (7) (10);
• A less treated infection or not treated at all increases the risk for the
patient to die;
• Long periods of infection increase the community health risks in public
places, where the infected individual interact with other people;
• New antibiotics (patents) inventions are required (11). These new
alternatives, less studied, can be toxic, have serious side effects or are less
effective (12);
• Antibiotic resistant bacteria can overcome human and animals resistance,
causing diseases that are not easy to cure (3);
• More expensive hospital stays (4).
3 Practical Alternatives
• Alternatives to antibiotics must gain interest and be
developed. These alternatives offer similar effect, and
economical values (e.g. probiotics and prebiotics).
• Animal welfare improvement, which means – welfare
principles: reduction of overcrowding conditions, general
hygiene, and infection control techniques.
• Since 2006, the EU has banned the use of antibiotics in
growth promotion (14).. Measures of this level must be
undertaken as soon as possible in countries like Albania.
Conclusions
•
•
•
•
•
Action plan is needed, looking at the
international approach;
Educational campaigns in different
levels;
Strengthening of the legislation;
Governmental and NGOs involvement;
Follow of successful examples, e.g.
Swedish animal farming.
References
1- Haxhiraj, E, The Secret of Emerging Diseases, Albania 2010, Biblioteka Kombetare, Book, 19-21.
2- EFSA Panel on Additives and Products or Substances used in Animal Feed (FEEDAP) ; Technical guidance - Update of the
criteria used in the assessment of bacterial resistance to antibiotics of human or veterinary importance [1]; EFSA-Q-2008-004
3- National Research Council, NRC (National Research Council, National Academy of Sciences). (1980). The effects on human
health of subtherapeutic use of antimicrobials in animal feeds. Committee to Study the Human Health Effects of Subtherapeutic
Antibiotic Use in Animal Feeds, Division of Medical Sciences, Assembly of Life Sciences. Washington, DC: National Academy of
Sciences, Office of Publications and NRC (National Research Council, National Academy of Sciences). (1999). The use of
drugs in food animals: Benefits and risks. Washington, DC: National Academy Press.
4- CDC, webpage, http://www.cdc.gov/drugresistance/about.html
5- Lindsay, J.A. (1997). Chronic Sequelae of Foodborne Disease. Emerging Infectious Diseases. Atlanta: Centers for Disease
Control and Prevention. On line: http://www.cdc.gov/ncidod/EID/vol3no4/lindsay.htm
6- JSC (Joint (Swann) Committee). (1960). The Use of Antibiotics in Animal Husbandry and Veterinary Medicine. Report to
Parliament. London: Her Majesty’s Stationery Office.
7- Levy, S. (1998, May 7). Multidrug resistance – A sign of the times. The New England Journal of Medicine (338), 19, 1376-1378.
8- Franklin, A. (1997, November 13). Antibiotic resistance in animal production: A threat to human and animal health. Scheele
Symposium, 1997. The threat of antibiotics resistance: A Nordic perspective. Stockholm: Swedish Academy of Pharmaceutical
Sciences.
9- Kolpin, D., Riley, D., Meyer, M.T., Weyer, P., Thurman, M. Pharm-chemical contamination: A reconnaissance for antibiotics in
Iowa streams, 1999. Workbook for the AFO Workshop. Animal Feeding Operations: Effects on hydrologic resources and the
environment. August 30-September 1, Fort Collins, Colorado. U.S. Geological Survey
10- MMWR. (1997, April 11). Multidrug-resistant salmonella serotype typhimurium – United States 1996. Morbidity and Mortalities
Weekly Review 46(14), 308-310.
11- Salyers, A. (1995). Antibiotic resistance transfer in the mammalian intestinal tract: Implications for human health, food safety and
biotechnology. Molecular Biology Intelligence Unit. Austin, TX: R.G. Landes Company.
12- Wegener, H.C. (1999, May 20). The consequences for food safety of the use of fluoroquinolones in food animals. The New
England Journal of Medicine (340),20, 1581-1582.
12 (a)- Huovinen, P. (1997, November 13). Immediate need for antibiotic policy in the community. Scheele Symposium, 1997, The
threat of antibiotics resistance: A Nordic perspective. Stockholm: Swedish Academy of Pharmaceutical Sciences.
13- CIWF website, http://www.ciwf.org.uk/news/factory_farming/defra_decision_increases_risks_to_human_health.aspx
14- Hughes P and Heritage J, Assessing quality and safety of animal feeds, FAO article, Antibiotic growth-promoters in food
animals, ftp://ftp.fao.org/docrep/fao/007/y5159e/y5159e05.pdf.
15- OIE website, http://www.oie.int/en/for-the-media/press-releases/detail/article/veterinary-services-in-africa-strengthen-theirsolidarity-by-establishing-a-regional-representation/
16- World Health Organization, 1996 report, 'Fighting Disease, Fostering Development',
17- University of Illinois, Applied Environmental Microbiology, 2007