AS the debate continues concerning the use of antibiotics in food animals and the relationship to drug-resistant infections in people, a team of interdisciplinary scientists at the Medical University of South Carolina (MUSC) and the Charleston Veterans Administration Medical Center Research Service reviewed published literature for evidence of a relationship between antibiotic use in agricultural animals and drug-resistant foodborne campylobacter infections in people, commonly known as campylobacteriosis.

According to the 2013 "Antibiotic Resistance Threats Report" from the Centers for Disease Control & Prevention, two of the 18 pathogens of concern in the U.S. may have a direct link to agriculture; one of those is campylobacter, which can cause foodborne illness when food is not properly handled and cooked, regardless of whether it carries any specific antibiotic resistance. Campylobacter is of concern because some people infected with the bacteria develop severe arthritis, while others may develop Guillain-Barre Syndrome, which is a leading cause of acute paralysis in the U.S.

The new study — conducted by veterinary and nutrition scientists and an infectious disease physician — reviewed 195 articles in the U.S., Canada and Denmark over the past five years and was published in the current issue of Critical Reviews in Food Science & Nutrition. Animals included in the reviewed studies were chickens, turkeys, pigs, beef cattle and dairy cows.

According to the findings, the overall prevalence of campylobacter and drug resistance found in the systematic review aligns with recent National Antimicrobial Resistance Monitoring System reports. The research team found no conclusive evidence of a definitive link between the use of antibiotics in food animals and the emergence of drug-resistant campylobacter.

However, the findings did lead the team to raise important concerns about campylobacter. For example, recent cases of campylobacter infections have been linked directly to drinking raw milk or eating food products made from raw milk. It is important to note that the U.S. Department of Agriculture and the Food & Drug Administration do not recommend consuming raw cow's milk.

"There is still much more research to be done. The agriculture and health care industries, along with the scientific community and government regulatory agencies, must work collaboratively with the human health community in order to ensure safe, humane and affordable food sources to the public," lead scientist Dr. M.A. McCrackin said.

Dr. Richard A. Carnevale, vice president for regulatory, scientific and international affairs at the Animal Health Institute, which funded the study, refers to the medical and veterinary collaboration as an "integrated, 'One Health' approach."

"The agriculture community recognizes that there is more that can be done to protect the effectiveness of antibiotics, which is the goal of both the animal and human health communities. By the end of the year, the agriculture community will be in full compliance with the FDA mandates — Guidance #209 and #213 — that eliminate the use of medically important antibiotics for growth promotion purposes and require veterinary approval for all remaining uses in feed through the Veterinary Feed Directive," Carnevale said.

Dr. Bernadette Marriott, principal investigator on the study, added, "Our research results underscore the need for both veterinarians and physicians to work together as we advance toward solutions to concerns about antibiotic resistance."

The MUSC authors noted that a similar systematic review of salmonella was also conducted, and the findings of that study are expected to be published next year.

Volume:88 Issue:09