It’s The Microbes That Will Get You

They say it’s the little things in life that really matter. It turns out they might be right. It also seems that it may be the little things that kill us in the end.

Our particular species of fun-loving bipeds has survived all manner of threat and danger over the millenia. Floods, fires, famine and even oversized, razor-toothed cats with a taste for our flesh.

But all the survival skills learned and passed down through the ages and generations may not protect us from the smallest threat of all: microbes.

Yes, humans are quite microbe-resistant, by and large. Our immune systems are robust and designed to take on any number of miniature invaders bent on wreaking havoc on our relatively fragile frames.

But the economic growth being experienced even in some of the previously poorest places on earth may be creating a new problem. Lots of folks in places like Africa, Latin America, India and China are seeing their increasing wealth reflected by the increased consumption of meat and dairy products. Africa’s meat consumption is up by over 50% while there’s a steak and burger (wings, chops, etc.) frenzy going on in Asia and Latin America, where it’s up by more than 67%.

Global shift to a plant-based diet, eh? Sure doesn’t look like it!

In response to skyrocketing demand, more animals must be bred and produced. The global animal husbandry industry has turned to antimicrobials to aid their production and breeding. The drugs are used to mitigate infection among animals bred in crowded conditions, but are also employed to drive weight gain, thereby improving profits.

Less disease and larger animals means more meat for hungry folks who can now afford this once-sparse luxury. All good, right? Wrong.

There are consequences to the rampant and indiscriminate use of these antimicrobial drugs. Perhaps the most alarming is the rapidly growing number of antimicrobial-resistant bacteria found across the planet. These drugs are becoming less potent against the bacterial invaders, and this has some potentially dire consequences for animals and possibly humans.

In industrialized nations, tracking the use of antimicrobials is easier than in low- and middle-income countries. There are established tracking systems in wealthier countries, monitored by well-funded agencies, mostly governmental, as well as established regulations and consistent documentation.

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Recently, a map of antimicrobial resistance in animals in low-and middle-income nations was published in the journal Science. A research team led by Thomas Van Boeckel, SNF Assistant Professor of Health Geography and Policy at ETH Zurich.

They started with the common food-borne bacteria Staphylococcus, Campylobacter, Salmonella and E. coli. They put together a large database, locating areas of antimicrobial resistance and specifying the animal species in which the resistance occurred.

A look at the map is a little frightening. Regions with high rates of antimicrobial resistance are found in Iran, Turkey, northeast India, northeast China and southern Brazil. Surprisingly, Africa largely avoided the map, except for Nigeria and the surroundings of Johannesburg. In these areas, the bacteria noted above have become resistant to a large cadre of drugs used both in animal and human medicine.

Commonly used anitmicrobials like tetracyclines, sulphanomides, penicillins and quinolones showed the highest resistance rates. In fact, in some regions, they have been shown to be completely useless in treating infections.

Researchers were alarmed by the findings. They created a new index to track the progression of the resistance of diseases to multiple drugs – the proportion of drugs tested in each region that have resistance rates higher than 50%. Here’s a slightly disturbing fact: globally, the index has tripled for pigs and chickens over the last 20 years. Right now, fully one-third of drugs used on chickens fails at a 50% or greater rate, with a quarter of drugs failing more than 50% of the time in pigs.

“This alarming trend shows that the drugs used in animal farming are rapidly losing their efficacy,” Van Boeckel says. The sustainability of the animal industry will be negatively effected, as well as, potentially, the health of consumers.

Particularly frightening is that antimicrobial resistance is rising in emerging and developing countries. The problem in these areas is fast growing meat consumption rates paired with largely unregulated access to veterinary antimicrobials. “Antimicrobial resistance is a global problem. There is little point in making considerable efforts to reduce it on one side of the world if it is increasing dramatically on the other side,” the ETH researcher says.

The researchers dug deep and wide to create their antimicrobial resistance maps. In this study, researchers from the Free University of Brussels, Princeton University and ETH collected thousands of publications and unpublished veterinary reports from across the globe.

In spite of this, there are still gaps in the researchers maps, as they were unable to map some areas, like regions in South America, where there seems to be a lack of publicly available data. “There are hardly any official figures or data from large parts of South America,” says co-author and ETH postdoctoral fellow Joao Pires. Pires was surprised that much more data was available from some African nations, where resources for collecting data seem to be more sparse, than South America.

The team has created an open-access web platform resistancebank.org to share their findings and gather additional data on resistance in animals. They’ve made it possible for veterinarians and state agencies to upload resistance data in their regions to the platform for sharing with interested parties.

Van Boeckel hopes that scientists from countries where resources are more limited and for whom the cost of academic journal publishing may be prohibitive will be able to gain recognition for their work and share findings on the platform. “In this way, we can ensure that the data is not just stuffed away in a drawer” he says, “because there are many relevant findings lying dormant, especially in Africa or India, that would complete the global picture of resistance that we try to draw in this first assessment. The platform could also help donors to identify the regions most affected by resistance in order to be able to finance specific interventions.”

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The web platform and its’ resources may help target interventions against antimicrobial resistance. It may also aid in the transition to more sustainable farming practices in countries at risk. “The rich countries of the Global North, where antimicrobials have been used since the 1950s, should help make the transition a success,” says Van Boeckel.

More economic development and success is leading many previously poor countries to a brighter future. That future includes former luxuries like readily available meat and dairy. But does that future also include drug-resistant microbes and bacteria? Does it include mutations of dangerous diseases and animal to human transmission? As fortunes rise in these nations, will the eventual cause of our demise as a species also rise?

There’s been a lot of talk in American media about “resistance.” I don’t think this is what that talk is referring to, but perhaps this is the resistance on which they really should be focused. Remember, it’s often the little things that create the biggest problems.

Keep the faith and keep after it!

Journal Reference – Thomas P. Van Boeckel, João Pires, Reshma Silvester, Cheng Zhao, Julia Song, Nicola G. Criscuolo, Marius Gilbert, Sebastian Bonhoeffer, Ramanan Laxminarayan. Global trends in antimicrobial resistance in animals in low- and middle-income countries. Science, 2019

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