Very bad drug-resistant bacteria outbreak (in Denmark) linked to pork products.
November 4, 1999
Bacteria Cases in Denmark Cause Antibiotics
Concerns in U.S.
By DENISE GRADY
An outbreak of severe, drug-resistant salmonella infections in 27 people
in Denmark, traced to meat from infected pigs, is being described by
American scientists as a warning on what could happen in the United
States unless steps are taken to limit the use of antibiotics in farm animals.
The episode in Denmark, in which 11 people were hospitalized and 2 of them
died, is especially worrisome because the bacteria had made them partly
resistant to fluoroquinolones, a class of antibiotics that doctors had
considered one of their most powerful weapons against severe cases of
salmonella and other bacteria that infect the intestinal tract. If those bacteria
invade the bloodstream, which occurs in 3 percent to 10 percent of
salmonella cases, the illness can be fatal.
"Fluoroquinolones become a drug of last resort for some of these infections,"
said Dr. Stuart Levy, director of the Center for Adaptation Genetics and Drug
Resistance at Tufts University. "If we're beginning to lose these drugs, where
do we go from here?"
Fluoroquinolones are the most recently approved class of antibiotics; nothing
comparable is expected to become available for several years.
Salmonella that are resistant to fluoroquinolones have not been detected in the
United States although they have turned up in Britain, Germany and France,
as well as Denmark. But, "resistance is a global issue," said Dr. Stephen F.
Sundlof, director of the center for veterinary medicine at the Food and Drug
Administration, which regulates the use of antibiotics in livestock and poultry.
"It potentially has an impact on everybody because of the global nature of
trade in foodstuffs, or people carrying organisms into other countries," Dr.
Sundlof said.
Fluoroquinolones are used in Denmark to treat some illnesses in pigs, and the
Danish researchers who studied the outbreak suggested that such use may
have fostered the growth of resistant bacteria, which then entered the food
supply. The outbreak, which occurred last year, is being reported today in
The New England Journal of Medicine.
Giving fluoroquinolones to pigs is not permitted in the United States, but the
drugs are used to treat sick cows on an individual basis, and they are given in
drinking water to entire flocks of 20,000 to 40,000 chickens or turkeys if any
bird appears ill.
Concerned that the use of antibiotics in livestock may be contributing to the
emergence of resistant bacteria that cause infections in people that are hard to
cure, the Food and Drug Administration is revising its guidelines for
approving and monitoring the use of the drugs in animals.
Dr. Sundlof said that the strain of salmonella that made people sick in
Denmark, known as DT104, is already resistant to five other antibiotics and
its incidence in this country has been rising.
A study last year by researchers from the Centers for Disease Control and
Prevention found it in 34 percent of cases salmonella cases in 1996.
Dr. Fred Angulo, an epidemiologist in the food-borne and diarrheal disease
branch at the centers, said that fluroquinolone-resistant strains of another
type of bacteria, campylobacter, began to turn up in people soon after the
drugs were approved for use in poultry.
But John Keeling, a spokesman for the Animal Health Institute in Washington,
a trade group representing makers of veterinary drugs, said it was yet to be
proved that fluoroquinolone use in the animals had any connection to the
illnesses in people.
Copyright 1999 The New York Times Company |
