Boy's Drug-Resistant Germ Tied to Antibiotics in Cattle

[Guest guest]

By Marc Kaufman

Washington Post Staff Writer

Thursday, April 27, 2000; Page A02

http://washingtonpost.com/wp-dyn/articles/A21262-2000Apr26.html

 

 

Researchers have concluded that a Nebraska boy's infection by salmonella

bacteria resistant to a widely used pediatric antibiotic came from cattle on his

farm.

 

The report has heightened concerns of public health officials that the routine

use of antibiotics by farmers to treat and promote the growth of livestock is

reducing the ability of similar antibiotics to cure humans of infections.

 

" To the extent this could become widespread, it poses a serious problem, " said

David Bell of the Centers for Disease Control and Prevention in Atlanta. " This

particular antibiotic is a drug of choice for treating children, and there is no

good alternative approved for them now. "

 

The report, in today's New England Journal of Medicine, is the first to identify

a case of someone in the United States becoming infected with salmonella

resistant to the antibiotic Rocephin. It was found in a 12-year-old boy from

western Nebraska, who suffered from diarrhea but recovered without

complications.

 

But the article brought a harsh reply from the Animal Health Institute (AHI),

which represents the makers of drugs for animals. The study's findings " do not

support the sweeping conclusions of the author, " the group said.

 

Using DNA typing and other molecular-level investigations, researchers from the

University of Nebraska Medical School and the CDC concluded that the

Rocephin-resistant salmonella found in the boy was the same as that found in the

cattle on his family's ranch.

 

" We don't know exactly how the [salmonella] was transmitted to the child, but we

believe it came from the cattle and so it was ingested by the boy in some form, "

said Paul Fey of the University of Nebraska Medical School, the study's lead

investigator.

 

The finding comes in the midst of a debate before the Food and Drug

Administration over whether to limit the farm use of antibiotics closely related

to those used in human medicine. More than a year ago, the FDA proposed

guidelines to limit the spread of antibiotic resistance, and late last year

claimed authority to require drug companies to prove any new animal antibiotics

won't dangerously increase antibiotic resistance in humans.

 

Both the livestock and animal pharmaceutical industries have argued that the

farm use of antibiotics is necessary and useful, and that the science linking

use of antibiotics on the farm to drug resistance in humans is inconclusive.

 

The AHI also criticized how the new study was conducted, writing that

" investigators could not determine how the child acquired the infection or if

the resistant strain of salmonella found in one of the cattle samples even

originated on the boy's own farm. "

 

The lead researcher, Fey, acknowledged that his team did not know what drugs the

cattle had been given, but said public health officials tried to contact the

veterinarian treating the cattle and never received a reply. Livestock producers

have generally taken the position that what drugs they provide their animals is

proprietary information they don't have to share with government officials.

 

The animal antibiotic Ceftiofur is closely related to Rocephin--also known as

Ceftriaxone--and is widely used to treat inflammation of the udder and

respiratory diseases in cattle, pigs and poultry.

 

The many strains of salmonella infect an estimated 1.4 million Americans yearly,

causing gastrointestinal distress that can lead to more complex bloodstream

infections, and approximately 400 die. Salmonella resistant to other antibiotics

have been traced back to farm use in the past.

 

In an editorial accompanying the report, Michael T. Osterholm, who was Minnesota

state epidemiologist for more than two decades, wrote that the study makes " a

convincing argument that the animal reservoir was the source of the patient's

infection and that the use of antibiotics in the cattle had a role in the

selection of the specific salmonella strain. "

 

 

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