tara c. smith, phd assistant professor department of [email protected] title the science is...
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Tara C. Smith, PhD Assistant Professor
Department of Epidemiology
http://www.idsociety.org/badbugsnodrugs.html
http://www.idsociety.org/badbugsnodrugs.html
MRSA alone: 94,000 invasive infections, 18,000 deaths per year
Single MRSA surgical site infection: $60,000
Anderson et al. PLoS ONE 2009; Klevens et al JAMA 2007 http://www.tpchd.org/files/library/77107b62d2b430c9.jpg
Estimated between 40% - 87% of antibiotic use in US is for animals (treatment and growth promotion)
Levy 1998; UCS 2001 http://honestmeat.typepad.com/honest_meat/images/2008/07/17/pig26.jpg http://www.archives.gov.on.ca/english/on-line-exhibits/agriculture/pics/3194_dairy_cattle_1020.jpg
Many drugs are used for both humans & animals
Includes penicillins, tetracyclines, macrolides, cephalosporins, lincosamides,
and others
Crowding & unhygienic conditions => amplification of resistant organisms
Spread => workers, community, general public
Photo credit: Jeff Vangua USDA Natural Resources Conservation Service.
4 million
http://www.agcensus.usda.gov/Publications/2007/Online_Highlights/County_Profiles/Iowa/cp99019.pdf http://quickfacts.census.gov/qfd/states/19000.html Images: http://www.ruralramblings.com/blog/uploaded_images/HEN-2-chicks-784085.jpg http://www.theage.com.au/ffximage/2006/05/01/0205PIGS_narrowweb__300x365,0.jpg http://www.smh.com.au/ffximage/2006/07/26/cattle26706_wideweb__470x313,0.jpg http://z.about.com/d/gonewengland/1/0/t/x/turkey-picture-2.jpg
19 million 65 million 4 million
3 million
Iowa’s Confined Animal Feeding Operations (CAFOs)
49% of 299 swine; 45% of 20 workers carried MRSA
MRSA in pigs in 4/9 confinement farms in Iowa (0/9 antibiotic-free farms)
“ST398”—common “pig-associated” strain
Mostly in contact with livestock (cattle & pigs)
Can cause skin & soft tissue infections; invasive disease
Ventilator-associated pneumonia; bacteremia; endocarditis; multiorgan failure; deaths reported
From Declercq et al. Infection. 2008 Dec;36(6):590-2.
Pig bite in Belgian farm worker
More than just ST398
“Human” strains of MRSA found in pigs—picking up additional antibiotic resistances? (esp. tetracycline)
“It appears worthwhile to point out that the mass feeding of antibiotic drugs in routine diets of poultry and other domestic animals, with its concomitant development of drug-fast strains of intestinal bacteria, presents potential hazards to both agricultural industry and the public health.”
Smith Lab
Shylo Wardyn MS, Megan Quick MPH (Research Assistants)
Blake Hanson, Kerry Leedom Larson,
Dwight Ferguson, Raj Nair (PhD students)
Mike Male, Sean O’Malley, Brett Forshey, Ashley O’Brien, Alpha Opese (MS, MPH students)
Sarah Farina, James Wu, Martin Dittmer (undergrads)
Funding: National Pork Board, NIOSH, AHRQ,
NIEHS, USDA
http://www.public-health.uiowa.edu/CEID/