While FDA fiddles, dangerous antibiotic-resistant Salmonella strikes again

Keep Antibiotics Working | Bob Liff | December 21, 2009

A recent outbreak of beef-borne Salmonella Newport in Colorado and other Western states was caused by a microbe resistant to cephalosporin antibiotics. These antibiotics continue to be used “off label” a year after the Bush Administration’s Food and Drug Administration tabled plans to ban this use.

The original FDA order in July 2008 came after routine surveillance showed that cephalosporin resistance in Salmonella had risen rapidly over the last 10 years. The order stated the "FDA is concerned that the extralabel use of cephalosporins in food-producing animals is likely to lead to the emergence of cephalosporin-resistant strains of foodborne bacterial pathogens.” The FDA order read, “If these drug- resistant bacterial strains infect humans, it is likely that cephalosporins will no longer be effective for treating disease in those people.”

FDA scientists were especially concerned about the risk to children because children get Salmonella more than other age groups and cephalosporin antibiotics are the drugs most often used by physicians for treating serious Salmonella infections in children.

In November 2008, the FDA withdrew its proposal under pressure from agribusiness interests. A year later, an estimated 68,000 Americans – including 5,000 young children – have been infected with cephalosporin-resistant Salmonella, according to an analysis of data collected by the Centers for Disease Control.

The Obama administration came into office promising to let scientists make science-based decisions. Yet this FDA has refused to reinstate its ban, even after Deputy FDA Commissioner Joshua Sharfstein, M.D. told a congressional committee last July the agency was comitted to tackling the problem of resistance related to livestock use of antibiotics.

While Obama’s FDA has failed to act, his US Department of Agriculture, for the first time in the history of meat inspections, began requiring packers to recall ground beef contaminated with Salmonella. In all three Salmonella beef recalls to date, the pathogen was antibiotic resistant.

The most recent recall occurred on December 4 for 22,723 pounds of ground beef produced by a Cargill-owned plant in Fresno, California. In August, 800,000 pounds of ground beef had been recalled from the same plant due to Salmonella contamination linked to an outbreak in Colorado and other Western states.

According to published reports of the recalls, about two dozen people have reportedly become ill in Colorado and Arizona. In both recalls, the strain of Salmonella was Newport, a type often found in cattle herds. What those reports have not said, however, is that the strain of Salmonella Newport identified as the cause of the outbreak was found to be resistant to cephalosporins.

“FDA has known for years about the problem of cephalosporin-resistant Salmonella,” said Steven Roach, the Public Health Program Director of Food Animal Concerns Trust. “Under industry pressure, it backed away from the opportunity to do something about the problem last year. Now we are seeing even more beef recalls and disease outbreaks.”

Roach adds that Department of Public Health and Environment (CDPHE) scientists in Colorado, where the outbreak was first recognized, told him that the samples were resistant to cephalosporins. Isolates have been sent to the CDC, which has not yet confirmed the results.

Food Animals Concerns Trust, or FACT, is part of the Keep Antibiotics Working (KAW) coalition that includes the Union of Concerned Scientists, the Institute for Agriculture and Trade Policy, the Humane Society of the United States and other health, agricultural, consumer, environmental and humane groups. Information on KAW is available at www.keepantibioticsworking.com.

The coalition supported the extralabel ban when it was announced last year, opposed its withdrawal, and in November sent a letter to the FDA asking the ban be reinstated. “We are going to need new miracles to replace the miracle drugs that no longer work because of the rise of antibiotic resistant microbes,” said Roach.

“It has been over a year since the FDA decided to ban extralabel cephalosporin drug use in livestock due to the unacceptable public health risk it poses,” KAW Chair Richard Wood wrote in a recent letter to Sharfstein. Wood called on the FDA to reinstate the ban to combat “the growing crisis of antimicrobial resistance related to veterinary drug use in the United States.”

In addition to pressuring the FDA on the ban, KAW is urging Congress to adopt the Preservation of Antibiotics for Medical Treatment Act (PAMTA), which would require drug companies to demonstrate to the FDA that the routine non-therapeutic use of the medications does not negatively impact human health. In essence, this would require older drugs to meet the same standard as drugs being approved today.

NOTICE: In accordance with Title 17 U.S.C. Section 107, this material is distributed without profit to those who have expressed a prior interest in receiving this information for research and educational purposes.

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