Our holiday season has begun with an ominous report: In China, bacteria with a dangerous new antibiotic-resistance gene have spread from livestock to people. This gene bestows resistance against colistin -- an antibiotic that has become our last hope for treating people infected with some of the worst superbugs. The scariest part is that the gene can make copies of itself and then jump between bacteria. History shows us that these mobile resistance genes can spread around the world quickly, silently hitchhiking in the guts of people and animals or on the surface of food. Consequently, this could be our last Thanksgiving when we can count on colistin to save us from superbug infections. Turkey meat in the U.S. is frequently contaminated with antibiotic-resistant bacteria, so as we prepare our feasts, let's take some time to be thankful for a few positive things regarding agricultural antibiotic use in the U.S., while recognizing that we still have a long way to go.
On Thursday morning, as you carefully pull the plastic wrap off of your turkey and try to put it in the trash without contaminating your kitchen, be thankful that in 2003, the FDA implemented Guidance #152, which raised the bar for introducing new antibiotics to food-animal production and protected antibiotics like carbapenems from being abused in agriculture. Unfortunately, many older antibiotics like tetracyclines, penicillins, and macrolides were grandfathered in for use in food animals. Millions of pounds of these life-saving antibiotics are routinely administered to livestock to prevent infections that occur as a result of overcrowded, unsanitary, and in some cases, downright cruel living conditions. As a result, the bacteria that contaminate our holiday meats are often resistant to these important antibiotics.
As you daintily pull the neck and all those "extra" parts out of the carcass, be thankful that in 2005, after a long battle with Bayer, the FDA successfully withdrew approval for Cipro-like drugs in U.S. poultry production. Cipro and related drugs have saved countless lives since being introduced to human medicine. When Enrofloxacin (a drug almost identical to Cipro) was introduced to poultry production, the CDC reported a rapid increase in Cipro-resistant human infections. Banning the drug in poultry production didn't totally reverse the resistance, but it did stop it from increasing in U.S. poultry. Regrettably, Enrofloxacin is still approved for use in other livestock species in the U.S. and in poultry in other countries, where it continues to foster the growth of Cipro-resistant bacteria.
As you rub the outside of the turkey with savory sticks of butter, be thankful that in 2012, the FDA banned the extra-label use of cephalosporins in food-animals (cephalosporins are critically-important antibiotics for people of all ages, but particularly important for children). Prior to this ban, American companies could inject cephalosporins into poultry eggs. This was supposed to ward off infections in chicks, but groundbreaking research from Canada showed that it also resulted in cephalosporin-resistant infections in people. These drugs are still allowed for use by U.S. turkey producers, who can (legally) inject them into newly hatched turkeys. And cephalosporin-resistant bacteria continue to contaminate U.S. turkey products today.
As you stuff the bird just before putting it in the oven, be thankful that the FDA finally implemented Guidance #209 to eliminate antibiotic growth promotion -- the all too common practice of feeding animals antibiotics to make them grow more efficiently. This is the most egregious abuse of antibiotics in livestock production and an obvious target for elimination. Sadly, the FDA took no meaningful steps to end routine disease prevention and many of the antibiotics that were once used for growth promotion will continue to be used, perhaps euphemistically, as "disease preventers."
As you wipe down your kitchen surfaces and wash your hands repeatedly, be thankful that colistin-like antibiotics were never actively marketed to food-animal producers in the U.S. The drugs have several FDA-approved uses in chicken, cattle and sheep, but none of the drug companies holding these approvals are actively marketing the drugs. If they ever start, then our own livestock production facilities could become breeding grounds for the colistin-resistant bacteria just discovered in China. China is one of the world's greatest consumers of colistin for livestock. Unfortunately, as long as colistin-like antibiotics are legal in U.S. agriculture, it's difficult for us to ask China to stop this suicidal practice.
So finally, after you've checked the thermometer to make sure that the deepest part of the stuffing and the turkey breast has hit 165° F, join hands with your loved ones and hope that the colistin-resistant bacteria in Chinese livestock don't make their way to the U.S. Make a family commitment to call on our policymakers to stand up to the drug and agriculture lobbyists and enact policies banning the use of colistin and other critically important antibiotics in food animals. Demand that the FDA ban the use of all antibiotics for routine disease prevention in livestock. And finally, before you dig into your feast, hope that we discover new antibiotics, and that we never allow them to be used to make cheap Thanksgiving turkeys.