SUPERBUGS: Campylobacter Joins the Resistance
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SUPERBUGS: Campylobacter Joins the Resistance
Campylobacter is the most common bacterial cause of food poisoning in the United States. One study found Campylobacter contaminating 98% of retail chicken meat, the most common cause of Campylobacter poisoning. And the bacterium is growing dangerously resistant to multiple classes of antibiotics. But we still have a few big-gun antibiotics left to deal with resistant bugs. So, for the time being (before the bacteria outsmart these new antibiotics as well), do we have good evidence showing that partially resistant bugs like Campylobacter currently pose a particular threat? We do now.
Typically, Campylobacter only causes a self-limited diarrheal illness ("stomach flu") which doesn't require antibiotics. If the gastroenteritis is particularly severe or if doctors suspect that the bug may be working it's way from the gut into the bloodstream, the initial drug of choice is typically a quinolone antibiotic like Cipro. Quinolone antibiotics have been used in human medicine since the 1980s, but widespread antibiotic-resistant Campylobacter didn't arise until after quinolones were licensed for use in animal feed as growth promoters in the early 1990s. In countries like Australia, which reserved quinolones for human use only, resistant bacteria simply do not exist.
When the FDA announced they were intending to join other countries and ban quinolone antibiotic use on U.S. poultry farms, the drug manufacturer, Bayer, sued the FDA. Bayer lost the lawsuit last year, but is currently appealing the decision. Meanwhile, poultry factories continue to spike the chickens' water supply with these antibiotics critical to human medicine. Evidence released in May 2005 found that retail chicken samples from such factories are more than 450 time more likely to carry antibiotic-resistant bugs. Even companies like Tyson and Purdue which supposedly stopped using antibiotics years ago are still churning out antibiotic-resistant bacteria-infected chicken. Scientists think the bacteria that became resistant years before are still hiding within the often dirt floors of the massive broiler sheds or within the piping of the water supply. Another possibility is that the carcasses of the chickens raised under so-called "Antibiotic Free" conditions are contaminated with resistant bacteria from slaughterhouse equipment which can process over 200,000 birds in a single hour.
In someone infected with Campylobacter, if the initial quinolone antibiotic isn't effective, doctors switch to stronger antibiotics reserved as a last resort. Does this delay lead to poorer patient outcomes? Scientists recently studied thousands of patients with Campylobacter infection to answer that question, and, indeed, the delay in treatment caused by quinolone-resistant Campylobacter led to up to ten times more complications--infections of the brain, the heart, and the most frequent serious complication they noted, death.
 Stern NJ, Line JE. "Comparison of three methods for recovery of Campylobacter spp. from broiler carcasses." Journal of Food Protection 1992;55:663-6; Price LB, et al. "Fluoroquinolone-Resistant Campylobacter Isolates from Conventional and Antibiotic-Free Chicken Products." Environmental Health Perspectives 113(2005):557-60.
 Price LB, et al. "Fluoroquinolone-Resistant Campylobacter Isolates from Conventional and Antibiotic-Free Chicken Products." Environmental Health Perspectives 113(2005):557-60.
 Hemls M, et al. "Adverse Health Events Associated with Antimicrobial Drug Resistance in Campylobacter Species: A Registry-Based Cohort Study." Journal of Infectious Disease 191(2005):1051.
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