Agencies Collaborate to Combat the Creation and Spread of “Super Bugs”

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Report highlights CDC’s efforts to combat the threat of antibiotic resistance.

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At least 23,000 people die every year in the United States due to infections from antibiotic-resistant bacteria.  Recognizing this public health threat, the Centers for Disease Control and Prevention (CDC) recently issued a report describing various known causes of antibiotic-resistance and four proposed actions for fighting back.  However, the CDC isn’t acting alone in its efforts to combat these “super bugs”—the Food and Drug Administration (FDA) and U.S. Department of Agriculture (USDA) have played key roles in monitoring trends in antibiotic resistance and may also need to implement new regulations to address potential food-related resistance causes.

The report recommends four “core actions” that can be taken to fight the growing threat of antibiotic resistance:

  • Preventing infections and the spread of resistant bacteria through changes at healthcare facilities, in the community, and in the meat industry
  • Tracking the origins and movement of antibiotic resistant bacteria
  • Improving the manner in which antibiotics are used
  • Developing new antibiotics and new tests to analyze resistant bacteria

The first proposed action focuses on taking different approaches to prevent infection and the spread of resistant bacteria. The FDA plays a key role in one of the approaches to accomplishing the first core action—improving regulation in the food-animal industry.  The CDC report discusses attempting to prevent antibiotic resistance in food, a purported link that meat industry organizations, such as the National Pork Producers Council, have denied.  In its recent threat report, however, the CDC firmly asserts that antibiotic resistant bacteria can originate in food, specifically meat.

In addition to working with the FDA to change regulation on foods, the CDC is working with the USDA to change regulation on animal feed and the uses of antibiotics in food animals. The widespread use of antibiotics in food-producing animals, just like human use, reportedly contributes to the creation of antibiotic-resistant bacteria.  Resistant bacteria in animals are especially concerning because people who consume these animals can develop drug-resistant infections from the bacteria carried on them.  The CDC recommends, therefore, that antibiotics in food-producing animals be used only under the supervision of a veterinarian to treat diseases and discontinuing the practice of using antibiotics to promote animal growth.

The second of the core actions proposed—tracking drug resistance patterns—also involves substantial collaboration with the FDA and USDA, specifically through the National Antimicrobial Resistance Monitoring System for Enteric Bacteria (NARMS). The NARMS program is a national health surveillance system established in 1996 to track changes in antibiotic resistance of bacteria. The CDC describes the program as an “interagency partnership”, since the FDA, USDA and CDC divide the responsibility of monitoring antibacterial resistance by focusing on retail meats, food animals, and humans, respectively.

Through this program, CDC is able to provide healthcare providers with updates on newly discovered resistant bacteria, how they are spreading, and ways to combat such bacteria. The CDC also gathers information on causes and risk factors associated with particular newly discovered infections and develops strategies to prevent those infections from spreading.

In addition to new regulations and enhanced health surveillance, the remaining core actions recommended by the CDC involve reducing infections in healthcare facilities and the community by providing better methods to track resistance, providing guidance for more effective antibiotic use, administering vaccinations, and protecting patients from infection through education and better hygiene practices.  The CDC further recommends more conservative use of antibiotics, referred to as “antibiotic stewardship,” and encourages the development of new antibiotics and diagnostic tests to keep up with the new resistant bacteria that are discovered.

In addition to the reported 2 million people annually infected with antibiotic resistant bacteria and the estimated $20 billion in associated healthcare costs, the CDC’s extensive collaborative efforts also appear to be motivated by the risk of loss of human life. “If we don’t take steps to slow or stop drug resistance, we will fall back to a time when simple infections killed people,” said Michael Bell, M.D., the Deputy Director of CDC’s Division of Healthcare Quality Promotion.