Kristof on MRSA: Good, but There’s Better Evidence

I’m always loath to criticize mainstream discussions of the antibiotic resistance, particularly when the link between antibiotic use in agriculture and antibiotic resistance is raised. But, while NY Times columnist Nicholas Kristof meant well, he missed the mark.

In his column about MRSA ST398, he describes things that might happen. Here’s one example:

Public health experts worry that pigs could pass on the infection by direct contact with their handlers, through their wastes leaking into ground water (one study has already found antibiotic-resistant bacteria entering ground water from hog farms), or through their meat, though there has been no proven case of someone getting it from eating pork. Thorough cooking will kill the bacteria, but people often use the same knife to cut raw meat and then to chop vegetables. Or they plop a pork chop on a plate, cook it and then contaminate it by putting it back on the original plate.

The problem I have with Kristof’s column is that MRSA ST398 isn’t a hypothetical. The reason the spread of MRSA ST398 into the healthcare system scares the crap out of me isn’t that it might happen: it’s already happened. We already have documented evidence from the Netherlands, where ST398 has started to show up in the healthcare system in agricultural regions of the country. And in Sweden, ST398 is present in the community.
These are countries with reasonably good antibiotic use policies, so I’m not exactly optimistic.
I’m glad Kristof raised the issue, but the reflexive conservative denialists will attack the column, when he could have provided much stronger evidence. During my time dealing with the possible approval of cefquinome for use in agriculture, I ran into to pork lobbyists. If this issue gets serious attention, I expect to see conservative think tanks milking ‘sound science’ by getting contributions from pork lobbyists to host ‘impartial’ round tables and so forth. One of the tactics they’ll use is to downplay the ‘seriousness’ of the crisis. And Kristof didn’t help there.
An aside: The other gambit the ag lobbies will use is analogous to the smoking lobby: we don’t know for certain, blah, blah, blah. In the antibiotic resistance surveillance field, it’s known as ‘statistically sound sampling.’

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3 Responses to Kristof on MRSA: Good, but There’s Better Evidence

  1. Pat Gardiner says:

    You are right.
    But I’m still absolutely delighted with the subject being in the national media.
    The debate, so long restrained by veterinary sponsored intimidation and dirty tricks in Britain, is now well under way in the United States.
    My personal view is that some of the strains (esp. USA300 )causing havoc in the US have no obvious direct relationship with pigs, but not all.
    ST398, newly arrived and now surging south from Canada, does. It is fully documented elsewhere in the world in humans and there have been suggestions it has reached upstate NY.
    The newsgroup is a major source of information for American investigators. The trail has been carefully laid, over years, for them to follow.
    In Britain we can at last get help and watch the democratic United States slowly close in for the kill on Britain’s corrupt veterinary industry.
    We still need to take urgent attention to protect our hospitals, however. Actions the Dutch took years ago.

    Pat Gardiner
    Release the results of testing British pigs for MRSA and C.Diff now! and

  2. Dave Roberts says:

    For the last 9 months I have been tracking the MRSA ST398 situation and have compiled an extensive research website that brings together information from over 70 sources. Visit link above for extensive background to this story and reinforcement of what Mike says here.

  3. Livestock producers in the U.S. have argued for years to obtain food labeling based on country of origin. Here is why it is so important. Many antibiotics and other pharmaceuticals that cannot gain approval through FDA are used in Canada and Mexico. Many more have gained approval but have more stringent withdrawal times when used in the U.S. Nevertheless, livestock fed across the border have regularly been shipped to the U.S. and purchased for consumption. So how does that protect us? Country of origin labeling has finally passed. I hope that consumers learn to understand the benefit of this choice.

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