tara c. smith, phd assistant professor department of ...tara-smith@uiowa.edu title the science is...

Tara C. Smith, PhD Assistant Professor

Department of Epidemiology

http://www.idsociety.org/badbugsnodrugs.html

http://www.idsociety.org/badbugsnodrugs.html

MRSA alone: 94,000 invasive infections, 18,000 deaths per year

Single MRSA surgical site infection: $60,000

Anderson et al. PLoS ONE 2009; Klevens et al JAMA 2007 http://www.tpchd.org/files/library/77107b62d2b430c9.jpg

Estimated between 40% - 87% of antibiotic use in US is for animals (treatment and growth promotion)

Levy 1998; UCS 2001 http://honestmeat.typepad.com/honest_meat/images/2008/07/17/pig26.jpg http://www.archives.gov.on.ca/english/on-line-exhibits/agriculture/pics/3194_dairy_cattle_1020.jpg

Many drugs are used for both humans & animals

Includes penicillins, tetracyclines, macrolides, cephalosporins, lincosamides,

and others

Crowding & unhygienic conditions => amplification of resistant organisms

Spread => workers, community, general public

Photo credit: Jeff Vangua USDA Natural Resources Conservation Service.

4 million

http://www.agcensus.usda.gov/Publications/2007/Online_Highlights/County_Profiles/Iowa/cp99019.pdf http://quickfacts.census.gov/qfd/states/19000.html Images: http://www.ruralramblings.com/blog/uploaded_images/HEN-2-chicks-784085.jpg http://www.theage.com.au/ffximage/2006/05/01/0205PIGS_narrowweb__300x365,0.jpg http://www.smh.com.au/ffximage/2006/07/26/cattle26706_wideweb__470x313,0.jpg http://z.about.com/d/gonewengland/1/0/t/x/turkey-picture-2.jpg

19 million 65 million 4 million

3 million

Iowa’s Confined Animal Feeding Operations (CAFOs)

49% of 299 swine; 45% of 20 workers carried MRSA

MRSA in pigs in 4/9 confinement farms in Iowa (0/9 antibiotic-free farms)

“ST398”—common “pig-associated” strain

Mostly in contact with livestock (cattle & pigs)

Can cause skin & soft tissue infections; invasive disease

Ventilator-associated pneumonia; bacteremia; endocarditis; multiorgan failure; deaths reported

From Declercq et al. Infection. 2008 Dec;36(6):590-2.

Pig bite in Belgian farm worker

More than just ST398

“Human” strains of MRSA found in pigs—picking up additional antibiotic resistances? (esp. tetracycline)

“It appears worthwhile to point out that the mass feeding of antibiotic drugs in routine diets of poultry and other domestic animals, with its concomitant development of drug-fast strains of intestinal bacteria, presents potential hazards to both agricultural industry and the public health.”

Smith Lab

Shylo Wardyn MS, Megan Quick MPH (Research Assistants)

Blake Hanson, Kerry Leedom Larson,

Dwight Ferguson, Raj Nair (PhD students)

Mike Male, Sean O’Malley, Brett Forshey, Ashley O’Brien, Alpha Opese (MS, MPH students)

Sarah Farina, James Wu, Martin Dittmer (undergrads)

Funding: National Pork Board, NIOSH, AHRQ,

NIEHS, USDA

http://www.public-health.uiowa.edu/CEID/

tara-smith@uiowa.edu