- A European Union report found high levels of drug-resistant bacteria in humans, animals and food
- Multidrug-resistant salmonella was noted as a particularly serious threat
- Countries that have taken steps to reduce the use of antimicrobials in animals have lower levels of antimicrobial resistance and decreasing trends
The threat of antimicrobial resistance is increasing around the globe, including in the European Union (EU), where the European Centre for Disease Prevention and Control (ECDC) and the European Food Safety Authority (EFSA) released a new report on this urgent matter.1
Antimicrobial resistance refers to microorganisms — bacteria, fungi, viruses and parasites — that, after exposure to antimicrobial drugs (such as antibiotics, antifungals, antivirals, antimalarials, and anthelmintics), evolve and become impervious to them.2
The resulting “superbugs” pose a serious threat to public health. In the EU, 25,000 deaths occur every year due to infections caused by antimicrobial-resistant bacteria alone.3
EU Reports High Levels of Drug-Resistant Bacteria, Especially Salmonella
Data submitted by 28 EU member states in 2015 revealed antimicrobial resistance remains high in bacteria from humans, animals and food in the E.U., with multidrug-resistant salmonella noted as a particularly serious threat.
Nearly 30 percent of the salmonella isolates that can cause illness in humans displayed multidrug resistance, including to sulfonamides (more than 32 percent), tetracyclines (28 percent) and ampicillin (nearly 28 percent).4
One particularly common type of salmonella in humans, monophasic salmonella typhimurium, had “extremely high” multidrug-resistance rates of 81 percent, leading Mike Catchpole, chief scientist at ECDC, to state:5
“Prudent use of antibiotics in human and veterinary medicine is extremely important to address the challenge posed by antimicrobial resistance. We all have a responsibility to ensure that antibiotics keep working.”
Infection with salmonella is the second-most common foodborne infection in the EU, second only to infections caused by campylobacter. Among campylobacter isolates from humans, “very high to extremely high” resistance to the drug ciprofloxacin was reported — in some cases 80 percent to 100 percent.6
Reducing the Use of Antibiotics in Food Animals Is Associated With Lower Rates of Antimicrobial Resistance
Of note, the report found lower levels of antimicrobial resistance in Northern and Western Europe compared to the Southern and Eastern regions. The differences most likely are due to differences in antimicrobial use, particularly in agricultural cases.
Marta Hugas, head of EFSA’s biological hazards and contaminants unit, said in a press release:
” … [C]ountries where actions have been taken to reduce, replace and re-think the use of antimicrobials in animals show lower levels of antimicrobial resistance and decreasing trends.”7
In animals and meat, meanwhile, the presence of superbugs was also concerning. The report noted that bacteria resistant to carbapenems, which are antibiotics typically used as a last resort when all other antibiotics have failed, were detected for the first time in EU animals and food.8
Resistance to colistin, another last-resort antibiotic, was also revealed, as was resistance to salmonella, campylobacter and E. coli in animals and meat. University of Minnesota’s Center for Infectious Disease Research and Policy (CIDRAP) reported:9
“Among the salmonella isolates from pig meat, the highest levels of resistance were reported for ampicillin (44.7 percent), sulfamethoxazole (48.5 percent), and tetracyclines (49.1 percent).
… Among salmonella isolates from fattening pigs, moderate or high to extremely high resistance was reported for tetracyclines and sulfonamides, with slightly lower levels of ampicillin resistance.
In C [campylobacter] coli isolates from fattening pigs, overall resistance was very high for ciprofloxacin (62.1 percent), nalidixic acid (60.8 percent), and tetracycline (66.6 percent), and high for erythromycin (21.6 percent).
In E coli from fattening pigs, high levels of resistance were found to tetracyclines (54.7 percent), sulfamethoxazole (44.2 percent), ampicillin (39.3 percent), and trimethoprim (35.3 percent), with 38.1 percent of isolates displaying MDR [multidrug resistance]. Resistance levels in indicator E coli isolates from calves were also high … ”
Antibiotic Resistance is Now Found in Every Country
The Review on Antimicrobial Resistance (AMR), which was commissioned in July 2014 by the UK Prime Minister and which produced its final report in 2016, further explained that without action to curb the growing rates of antimicrobial resistance worldwide, we’re headed for an era where antibiotics stop working and “we’re cast back into the dark ages of medicine.”11
According to the AMR, antibiotic-resistant infections may lead to 50,000 deaths every year in the U.S. and EU, while:12
“The global burden of infections resistant to existing antimicrobial medicines is now growing at an alarming pace. Drug-resistant infections are already responsible for more than half a million deaths globally each year.
Early research commissioned by the Review suggests that if the world fails to act to control resistance, this toll will exceed 10 million each year by 2050 and have cost the world over 100 trillion USD in lost output.”
Why Is Antimicrobial Resistance on the Rise?
Antimicrobial resistance is a natural phenomenon, which occurs when a select few microbes survive treatment with antimicrobial drugs, often via genetic changes, and then grow and thrive.
“This leads to antibiotics becoming less effective over time and in many extreme cases, ultimately useless,” according to AMR. But the review notes that antimicrobial resistance is a growing threat today for two main reasons:13
- The use of antimicrobials has increased, which means microbes are exposed to many such drugs, and in greater concentrations, which increases the likelihood of resistance developing
- There are very few new drugs in development, especially in the case of antibiotics, to take the place of the drugs rendered ineffective by growing resistance
In conventional medicine, the lack of rapid diagnostic tests to identify disease-causing microbes is adding to the problem, as doctors may be forced to rely on broad-spectrum drugs that may not end up curing the disease (but at the same time expose the person to drugs that increase the risk of drug resistance).
The review also highlights the role of antibiotics used for animals, often for purposes of promoting growth, not treating disease, along with untreated waste products that allow drug resistance to be spread through the environment.14 Vytenis Andriukaitis, EU commissioner for health and food safety, said in a press release:15
“Antimicrobial resistance is an alarming threat putting human and animal health in danger. We have put substantial efforts to stop its rise, but this is not enough. We must be quicker, stronger and act on several fronts.”
Some Experts Say ‘Finishing the Entire Round’ of Antibiotics May Make Resistance Worse
If you’ve ever been prescribed antibiotics, you’ve likely heard the advice to finish the entire prescription, even if you feel better after just a couple of days. This is important, it’s said, because stopping early could allow some bacteria to survive, increasing the risk of antibiotic resistance.
In a report by STAT, it’s revealed, however, that a growing number of experts believe this rationale “doesn’t make any sense,” and taking antibiotics longer than necessary may actually be leading to increased drug resistance.16
The issue has become so pressing, and the number of critics of the old “finish the entire prescription” mantra so large, that it’s going to be examined at a March 2017 WHO meeting in Geneva, Switzerland.
The suggestion to continue antibiotic treatment after the resolution of symptoms was started when antibiotic resistance was not a concern, and is done to prevent relapses, not resistance, according to a report prepared by the WHO Expert Committee on the Selection and Use of Essential Medicines.17
They cite multiple studies that show shorter may be better when it comes to antibiotic treatment. According to one review published in JAMA Internal Medicine in September 2016:18
“Other than tuberculosis — which is caused by a very slowly replicative organism that spends much of its time in a nonreplicating state — for every bacterial infection for which trials have compared short-course with longer course antibiotic therapy, short-course therapy has been just as effective, and with reduced selective pressure driving resistance.
Use of shorter courses of antibiotic therapy is therefore greatly preferable to longer courses of therapy … Health care professionals should be encouraged to allow patients to stop antibiotic treatment as early as possible on resolution of symptoms of infection.
Ultimately, we should replace the old dogma of continuing therapy past resolution of symptoms with a new, evidence-based dogma of “shorter is better.”
In a sign that even the U.S. Centers for Disease Control and Prevention (CDC) may be open to this new dogma, at the end of the conventional advice to “not stop taking the antibiotics early,” they’ve added the caveat, “unless your healthcare professional tells you to do so.”19
Sanderson Refuses to Budge on Antibiotics
A number of poultry producers have already taken steps to cut down or eliminate antibiotics from their production. Tyson, Pilgrim’s Pride and Foster Farms have all announced they’re implementing procedures to reduce their use.
But this isn’t the case with Sanderson Farms, the third-largest poultry producer in the U.S. and also the only large producer that has refused to commit to limiting their use. In February 2017, a Sanderson Farms shareholder proposal that requested the company phase out the use of medically important antibiotics even failed to pass.20
The company has stated that using antibiotics preventively in food animals is not dangerous to human health and continues to use two antibiotics — gentamicin and virginiamycin — that are important for treating human infections.21
In May 2016, I urged you to pressure Sanderson Farms to come to its senses and join other major poultry producers in taking proactive steps to reduce its antibiotic use. Remarkably, the company decided to go public with its decision to continue using antibiotics instead, saying the antibiotic-free chicken trend is nothing but a marketing ploy devised to justify higher prices!
In reality, it’s known that when animals are given antibiotics, it promotes drug resistance in the microbes found in and on the animal, and those drug-resistant bacteria can then be spread to those who handle or eat the tainted meat.
Action Steps to Avert the Impending Crisis
The AMR included 10 steps to avert the crisis of antimicrobial resistance that is creeping over the globe. As you might suspect, one of them is to eliminate the unnecessary use of antibiotics in farming and ban agricultural use of antibiotics needed as a last-line of defense in human medicine.22
To encourage this process, the report suggests meats should be clearly labeled to help consumers make informed choices about whether they want to buy meats raised with antibiotics. Other action steps noted in the report include:
- Improve sanitation: Developed countries need to focus on reducing hospital-acquired infections, while poor nations need to improve general living conditions with access to clean water and better sanitation and waste management. According to the report, economic development is critical, as improved sanitation alone could eliminate the need for 300 million courses of antibiotics given to treat diarrhea each year.
- Implement a global surveillance network to better understand how and where antibiotics are being used, and how resistant microbes are spreading and affecting various drugs.
- Eliminate unnecessary use of antibiotics in human medicine. In the U.S. only about one-quarter of all prescriptions for antibiotics are actually medically necessary and/or appropriate. The vast majority of people who get them have viral infections that do not respond to antibiotics. Part of the plan would be to improve diagnostic tests to identify bacterial infections and the most appropriate antibiotics to treat them.
As Drug-Resistance Spreads, What Can You Do?
High-quality colloidal silver may be a valuable addition to your medicine cabinet. The antimicrobial properties of silver have been known since 400 B.C., and silver was commonly used as an antimicrobial agent in wound management until the early 20th century. Its usage only diminished once antibiotics were introduced in the 1940s.
Low doses of silver can make antibiotics up to 1,000 times more effective and may even allow an antibiotic to successfully combat otherwise antibiotic-resistant bacteria.23 On a broader scale, the problem of antibiotic resistance really needs to be stemmed through public policy on a global level, but the more people who get involved on a personal level, the better. Such strategies include:
Using antibiotics only when absolutely necessary
Antibiotics are typically unnecessary for most ear infections, and they do NOT work on viruses. They only work on bacterial infections and, even then, they’re best reserved for more serious infections.
Taking an antibiotic unnecessarily will kill off your beneficial gut bacteria for no reason at all, which could actually make it more difficult for you to recover from your illness. If you do take a course of antibiotics, be sure to reseed your gut with healthy bacteria by eating fermented foods or taking a supplement.
As an all-around preventive measure, make sure your vitamin D level is optimized year-round, especially during pregnancy, along with vitamin K2. A number of other natural compounds can also help boost your immune system function to help rid you of an infection, including vitamin C, oil of oregano, garlic, Echinacea and tea tree oil.
Manuka honey can also be used for topical applications, as it’s effective against many bacteria, including some resistant varieties, such as MRSA.
Avoiding all antibacterial household products
This includes items such as antibacterial hand sanitizers and wipes, toothpaste, deodorants and detergents, as these too promote antibiotic resistance.
Properly washing your hands with warm water and plain soap, to prevent the spreading of bacteria
Be particularly mindful of washing your hands and kitchen surfaces after handling raw meats from CAFOs, as about half of all meat sold in grocery stores around the U.S. is likely to be contaminated with potentially dangerous bacteria.
Purchasing organic, antibiotic-free meats and other foods
Reducing the spread of antibiotic-resistant bacteria is a significant reason for making sure you’re only eating grass-fed, organically raised meats and animal products.
Besides growing and raising your own, which may not be an alternative for most people, buying your food from responsible, high-quality and sustainable sources is your best bet, and I strongly encourage you to support the small family farms in your area.