@農자료창고

While nearly every major health organization in the country has sounded the alarm over rising rates of antibiotic resistant bacteria, and the U.S. Food and Drug Administration (FDA) has released new data showing an increase in antibiotic use by the livestock sector, an American Meat Institute website continues to claim that everything is just fine in the meat and poultry industry.  Here I debunk some of the misleading claims now posted at AMI’s “MeatMythCrushers” website:

FACT:  FDA does not limit the amount of antibiotics used by livestock producers, although MeatMythCrushers would have us believe that FDA is carefully regulating this problem.  In fact, the FDA oversees the registration and labeling of drug products but it does not limit how much or how often veterinarians can prescribe these drugs and many are available to livestock operators “over-the-counter” without need for any veterinary oversight.  Furthermore, because the agency acknowledges the health threat posed by over-use of medically important antibiotics in animal agriculture, it recently issued a “voluntary guidance” to industry in 2012, recommending — but not requiring — antibiotic use reductions.  

Furthermore, FDA is very clear that livestock use of medically important antibiotics poses a health risk and recently stated: "Antimicrobial resistance, and the resulting failure of antimicrobial therapies in humans, is a mounting public health problem of global significance.  This phenomenon is driven by many factors including the use of antimicrobial drugs in both humans and animals.”

FACT:  Human use and livestock use of antibiotics contributes to the problem of increasing antibiotic resistance by harmful bacteria — not just human use as MeatMythCrushers suggests.  There is no question that over-use of antibiotics by people is an important part of the problem.  But MeatMythCrushers is clearly raising this argument to distract us from the role of animal agriculture in creating this problem. 

The American medical community is united when it comes to the issue of antibiotic resistance and the contribution of livestock use of antibiotics to the problem.   The American Medical Association; American Academy of Pediatrics; American Public Health Association; Infectious Diseases Society of America; Johns Hopkins Center for a Livable Future, Bloomberg School of Public Health; National Foundation for Infectious Diseases; the Pediatric Infectious Diseases Society and others have all declared that the “Overuse and misuse of important antibiotics in food animals must end, in order to protect human health.”

And in 2003, the Institute of Medicine of the National Academy of Sciences wrote: “Clearly, a decrease in the inappropriate use of antimicrobials in human medicine alone is not enough. Substantial efforts must be made to decrease inappropriate overuse of antimicrobials in animals and agriculture as well.”

FACT:  Livestock industry use of antibiotics has been increasing.  While the American Meat Institute claims that antibiotic use in meat production has been “relatively steady over time,” nothing could be further from the truth.  FDA reports show that antibiotics sold for use in livestock operations have quadrupled since 1970, from about 7 million pounds in 1970[1]  to nearly 30 million pounds in 2011.  Of this 30 million pounds,over two-thirds are medically important for humans.

FACT:  About 80% of all antibiotics sold in the United States are sold for livestock use.  MeatMythCrushers tries to cloud that statistic by questioning an estimate published by the Union of Concerned Scientists in 2001. In fact, the UCS was very clear at the time that they were estimating that 70 percent of antibiotics produced in the U.S. are fed to livestock.  It wasn’t until a decade later, in 2011, that the FDA issued its first public statement on this topic, confirming that the percentage is even higher — about 80% of antibiotics are sold for use in animal agriculture.

Even if you exclude the antibiotics that are not considered medically important, over 70% of antibiotics that are medically important are sold for use by the meat industry.

FACT:   Antibiotic resistant superbugs bred in livestock facilities do threaten human health. The American Meat Institute tries to dispute this fact, but once again the science is not on their side.  Leading health organizations agree that life-saving antibiotic medicines are no longer working to treat infections in people and that massive use of these drugs in the livestock sector are part of the problem.  The Centers for Disease Control and Prevention (CDC) wrote in 2010 that there is “strong scientific evidence of a link between antibiotic use in food animals and antibiotic resistance in humans.”   Numerous peer reviewed scientific journal articles have documented the proliferation of antibiotic resistant superbugs in feedlots, their escape to the environment, the transfer of antibiotic-resistant “traits” from these superbugs to other bacteria, and transmission to humans.   (Pew Charitable Trusts maintains a partial bibliography ).  The World Health Organization reports the “evidence shows that pathogens that have developed resistance to drugs in animals can be transmitted to humans.”

FACT:  Model regulations in Denmark demonstrate that livestock producers can drastically reduce antibiotic use while remaining profitable.  The American Meat Institute tries to discredit Denmark’s groundbreaking ban on non-therapeutic antibiotic use in the meat industry, claiming the ban didn’t reduce the amount of drugs used.   But,the most recent update from Denmark reports that since 1994, the total consumption of antibiotics by livestock decreased by 51% while meat production actually increased by 17%.  Farmers in Denmark are producing more meat with fewer antibiotics.  Danish datashow a decrease in antibiotic resistance in food animals and on retail meat since the 1994 policy changes, in most cases.  Changes in antibiotic resistance in humans is more complicated to track because there are many more variables involved, but even so, for some antibiotic resistant infections, scientists have observed a difference in rates of antibiotic-resistant infections since Denmark’s ban. For example, Campylobacterinfections in humans that were associated with travel outside of Denmark demonstrated a significantly higher level of antibiotic resistance.  In addition, it has been reported that “the prevalence of vancomycin-resistant Enterococcus faecium from humans has decreased since avoparcin was banned for use in animals in 1995.”

Last year, the Food and Drug Administrationproposed a set of voluntary "guidelines"designed to nudge the meat industry to curb its antibiotics habit. Ever since, the agency has been mulling whether and how to implement the new program. Meanwhile, the meat industry has been merrily gorging away on antibiotics—and churning out meat rife with antibiotic-resistant pathogens—if the latest data from the FDA itself is any indication.

The Pew Charitable Trusts crunched the agency's numbers on antibiotic use on livestock farms and compared them to data on human use of antibiotics to treat illness, and mashed it all into an infographic, which I've excerpted below. Note that that while human antibiotic use has leveled off at below 8 billion pounds annually, livestock farms have been sucking in more and more of the drugs each year—and consumption reached a record nearly 29.9 billion pounds in 2011. To put it another way, the livestock industry is now consuming nearly four-fifths of the antibiotics used in the US, and its appetite for them is growing.

Not surprisingly, when you cram animals together by the thousands and dose them daily with antibiotics, the bacteria that live on and in the animals adapt and develop resistance to those bacteria killers. Pew crunched another new set of data, the FDA's latest release of results from its National Antimicrobial Resistance Monitoring System, or NARMS, which buys samples of meat products and subjects them to testing for bacterial pathogens. Again, the results are sobering. Here a a few highlights pointed to by Pew in an email:In an email, a Pew spokesperson added that while  the American Meat Institute reported a 0.2 percent increase in total meat and poultry production in 2011 compared to the previous year, the FDA data show that antibiotic consumption jumped 2 percent over the same time period. That suggests that meat production might be getting more antibiotic-intensive.  

• Of the Salmonella on ground turkey, about 78% were resistant to at least one antibiotic and half of the bacteria were resistant to three or more. These figures are up compared to 2010. 

• Nearly three-quarters of the Salmonella found on retail chicken breast were resistant to at least one antibiotic. About 12% of retail chicken breast and ground turkey samples were contaminated with Salmonella.

• Resistance to tetracycline [an antibiotic] is up among Campylobacter on retail chicken. About 95% of chicken products were contaminated with Campylobacter, and nearly half of those bacteria were resistant to tetracyclines. This reflects an increase over last year and 2002.

Takeaway: While the FDA dithers with voluntary approaches to regulation, the meat industry is feasting on antibiotics and sending out product tainted with antibiotic-resistant bugs.

2011년 미국의 축산업에서 사용된 항상제의 양... 1만3562톤. 

인간에게 처방된 약의 약 4배에 이릅니다.

우리는 지금 고기를 먹는 건가요, 뭔가요? 

대량 밀집사육 방식은 짐승에게도, 사람에게도 몹쓸 짓입니다.

출처 식품의약청

연도별 동물용 항생제 판매 실적(‘03-‘09)

국가항생제내성 안전관리사업

❍ 목적 : 국가차원의 항생제내성 감소 안전관리체계 구축 및 위해관리방안 마련

❍ 사업기간 : ‘03 ~ ‘12

❍ 추진체계

- 식약청을 중심으로 보건복지가족부, 농림수산식품부, 환경부 등 참여

- 국정현안정책조정회의 결과(2007.12.27)에 의한 부처별 업무체계 재정비

※ 업무분담체계 : 임상(복지부), 비임상(식약청), 지원․조정(국무총리실)

❍ 주요 추진사업

- 항생제 내성실태, 사용량, 사용실태 분석 및 항생제내성 저감화 방안 수립

- 대국민 교육·홍보 및 항생제내성관리 국제협력 인프라 구축

❍ 주요성과

- 배합사료 첨가용 동물용의약품 단계적 사용 금지(53종(‘03)→16종(’09))

- 인수공용 퀴놀론계 항생제 4종 133품목 사용 금지(‘08)

- 무항생제 축산물 인증제 실시

- 축수산물 동물용 항생제 잔류기준 설정 : 58종(‘05) → 81종(’09)

- 항생제 사용량 및 항생제 내성률 감소

․ 항생제 사용량 : 1,553톤(’05)→ 998톤(36% 감소, ’09)

․ 대장균 테트라싸이클린 내성률(동물평균) : 80%(’05) → 69%(’08)

- 소비자 인식도 향상

․ 항생제내성 인식도 개선 : 28.5%(‘04) → 75.9%(’09)

- 각종 홍보 및 교육 자료 작성․배포

- 식약청 주관으로 국제식품규격위원회(CODEX) 항생제내성 특별위원회 운영

․ WHO/FAO등 국제기구와 연계하여 항생제내성 위해분석 국제지침 표준안 확립(‘09)

․ ‘10년 제4차 CODEX 항생제내성 특별위원회(무주)에서 국제표준으로 확정 예정

❍ 향후 대책

- 올바른 항생제사용을 위한 교육 및 홍보 지속 추진

- 축산․수산․환경․식품에 대한 항생제내성 실태조사 지속 추진

- 항생제내성 위해관리 국제지침에 의한 국내 항생제내성 위해평가

http://www.propublica.org/special/a-history-of-fda-inaction-on-animal-antibiotics

30년 전, FDA는 건강한 가축에게 먹이는 항생제가 인간 건강에 위험할 수 있다고 조사하고 일부 약품을 금지하겠다고 발표했다. 그러나 몇 년 동안비용 상승을 우려하는 산업계의 더 많은 연구와 압박으로 모든 것이 완화되었다. 가축에게 항생제를 남용하는 것이 인간에게 치명적인 항생제 내성을 확산시킬 수 있다는 과학적 증거의 쇄도에 대응하여, 미국 지방법원은 최근 항생제를 섞은 사료를 제한하는 조치를 취하도록 명령했다. 여기 우리는 FDA의 동물 항생제에 대한 나태한 역사를 추적했다. (위의 링크로 들어가면 아래와 같은 자세한 표를 볼 수 있음)

http://www.npr.org/blogs/thesalt/2012/02/21/147190101/how-using-antibiotics-in-animal-feed-creates-superbugs

EnlargeScott Olson/Getty Images

Many livestock groups say there's no evidence that antibiotics in livestock feed have caused a human health problem, but researchers beg to differ.

연구자들은 과학자, 정부 관리, 농기업 지지자가 몇 년 동안 논쟁한 어떠한 것에 대해 억지로 동의해야 했다: 가축 사료의 항생제가 인간을 위협할 수 있는 항생제 내성 세균을 야기할 수 있는지.

미국 미생물학회에서 출간한 mBio라는 학회지에 실린 연구는 항생제에 민감한 포도상구균이 어떻게 인간에서 돼지로 전해지고, 그것이 항생제인 테트라사이클린tetracycline과 메티실린methicillin에 대한 내성을 갖는지 밝혔다. 그 뒤 항생제 내성의 포도상구균이 다시 인간에게 돌아온다는 것을 알아냈다.

"슈퍼버그superbug의 탄생을 살펴보는 것 같다"고 응용유전체학연구소(Translational Genomics Research Institute)의 Lance Price는 말한다.

Price와 19개국의 동료들은 밀접하게 관련된 변종인 CC398과 88이라 불리는 포도상구균에 대한 전체 게놈 분석을 실시했다. CC398, 이른바 MRSA 또는 메티실린 내성 황색 포도상구균(methicillin-resistant Staphylococcus aureus)은 지난 10년 동안 돼지에게서 발생하여 소와 가금류에게까지 널리 퍼졌다.

유전자 분석으로 연구의 저자들은 항생제에 민감한 인간의 조상으로 돌아가 가축 세균의 혈통을 추적할 수 있었다. Price 씨는 동물의 박테리아가 가까이 노출된 가축을 통해 인간에게로 돌아왔다는 것을 의심할 여지가 없다고 한다. 

미국 미생물학회에 따르면, 이 "돼지 MRSA"이 미국에서 팔리는 모든 육류 표본의 약 절반에서 발견되었다고 한다. 고기에서 발견된 포도상구균 대부분은 잘 익히면 없어지지만,  안전하게 처리하지 않거나 다른 주방기구와 교차오염을 일으키면 여전히 소비자에게 위험을 일으킬 수 있다.

Price 씨는 가축에게 직접적으로 노출된 사람들을 통해 인간에게 새로운 내성 세균이 퍼지게 될 수 있다고 말했다. 

"처음에 우린 늘 가축 노출에 대해 다시 추적할 수 있었다"고 Price 씨는 말한다. "그러나 현재 우리는 다시 추적할 수 없는 내성의 사례를 발견하기 시작하고 있다. 그래서 말하자면 기어를 변속하고 있으며, 사람에서 사람으로 전염되는 능력을 갖추고 있다고 생각한다."

Price 씨는 새로운 데이터가 주요 공중보건 문제가 될 수 있다는 조기 경보를 제공한다고 한다.

그는 "이것이 일어나는 걸 보고 있다"고 한다. "문제는 앞으로 우리가 항생제 사용을 억제하지 않으면 얼마나 자주 일어날 것이냐는 점이다."

지금까지 이러한 가축에서 유래된 인간 MRSA 감염의 사례는 별로 없다. 그러나 네덜란드의 일부 지역에서는 4건 가운데 1건이 인간 MRSA 사례로 일어났다 —그것이 광범위하게 퍼질 가능성이 있음을 암시한다.

또 다른 연구의 저자 Paul Keim 씨는 "우리의 부적절한 항생제 사용이 ... 현재 우리에게 되돌아오고 있다"는 사실을 보고서가 밝히고 있다고 한다. 그는 해결책은 분명하다고 한다 — 유럽연합에서 했듯이 가축 사료에 항생제 사용을 금지하기.

주로 사료에 넣어 성장을 촉진시키고 대규모 사육장에서 감염의 발생을 완화시키려고 동물에게 먹이는 대부분의 항생제는 미국에서 팔렸다.

많은 사람들이 가축 사료에 항생제를 사용하는 것이 인간 건강에 문제를 일으킨다는 증거가 없다고 이야기한다. 

"박식한 과학자와 공중보건 전문가 대부분은 인간의 항생제 내성 문제가 압도적으로 인간에게 사용하는 항생제 때문이라는 사실을 인정하고 있다"고 미국 육류협회는 말한다.

새로운 보고서는 가축에게 사용하는 항생제에 대한 오래된 논쟁에 기름을 붓고, 정부에서 책임을 지고 그것을 규제하라고 한다. 12월에 FDA는 가축과 가금류의 사료에 사용되는 페니실린과 테트라사이클린이란 두 항생제에 대한 승인을 그만두자는 1977제안을 철회했다. 그 대신 육류업계의 "자발적인 개혁"을 통해 사용을 제한하는 데 초점을 맞추자고 했다.

그 뒤 1월에 부분적인 반전에서 식품의약청은 동물 사료에서 세팔로스포린cephalosporins이란 한 종류의 항생제를 금지했다.

After nearly succumbing to an antibiotic-resistant infection contracted from one of his hogs, Russ Kremer went cold turkey. He exterminated his diseased pigs and swore off the antibiotics he'd long-used to boost his herd's growth and prevent the illnesses so common in concentrated animal feeding operations, or CAFOs.

Now, more than 20 years later, he says his farm is organic, sustainable, humane and still nearly as efficient as the typical industrial CAFO. Plus he's eliminated the $16,000 a year he used to spend on veterinary and drug bills. And he hasn't sacrificed his pigs' health in the process. If anything, the opposite is true for Fred, Barney, Wilma, Pebbles, Bamm-Bamm and the other 500-some pigs that roam his 150-acre farm.

"My mortality rate is less than 1 percent after they leave their mother. In the industry, many people are seeing a 5 to 10 percent loss," Kremer, now president of Ozark Mountain Pork Cooperative in Missouri, told The Huffington Post. "I don't even own a syringe anymore."

Better yet, he has remained healthy himself.

Kremer's story exemplifies the findings of a growing number of scientific studies on the effects of antibiotic use in livestock. As HuffPost previously reported, the 29 million pounds of antibiotics given to livestock every year -- about four times the amount consumed by people, and mostly used at sub-therapeutic doses -- appears to be contributing to a rise in drug-resistant infections in both animals and people. The most infamous of the microbes: methicillin resistant Staphylococcus aureus, better known as MRSA.

"We've worked our way into a pickle," said David Wallinga, a senior adviser at the Institute for Agriculture and Trade Policy. The more antibiotics we use, the more microbes become resistant to those drugs -- even to our "biggest guns." It's a microscopic survival of the fittest.

Wallinga and his colleagues recently found drug-resistant microbes in 65 percent of about 400 pork products sampled from a dozen grocery stores across Iowa, Minnesota and New Jersey. Nearly 7 percent of the products had measurable amounts of MRSA, according to their study, published in January in the journal PLoS onE.

To the team's surprise, MRSA thrived in both conventional meat and meat labeled as antibiotic-free. (The "antibiotic-free" label is not regulated.)

At first glance, this finding might contradict other research, such as a study also published in January from the National Animal Disease Center (NADC) in Ames, Iowa. The intestines of piglets raised with antibiotics added to their feed accommodated both a greater number and wider variety of antibiotic resistance genes than the intestines of pigs not fed the drugs, according to that research. The treated pigs' innards were also colonized by more E. coli.

Still, both groups of pigs carried at least some resistant genes, the information that tells a microbe how to evade microbe-killing drugs. only the presence or absence -- not quantity of MRSA -- was measured in the pork study.

"We find antibiotic resistance genes quite prevalent in all pigs, irrespective of antibiotic feeding. We think this may be partially due to the fact that at least in pig growing regions, the background flora that they pick up is already enriched with antibiotic resistance genes," said James Tiedje, a microbiologist at Michigan State University and researcher on the study.

This concept was illustrated in yet another study published last year. Wild pigs from an island off the coast of South Carolina were compared to organically raised pigs in the Midwest. In this case, the guts of the wild pigs had 1,000-fold fewer bacteria resistant to the tetracycline class of antibiotics compared to their organic counterparts. (An organic label does imply antibiotic-free certification.)

Kremer is well aware that antibiotic residue can persist in the environment and lead to resistance long after the last dose of antibiotics was used on that land. Fortunately, he set up his new operation on land that -- as far back as he's aware -- had only been used for organic farming. And he made every effort not to introduce any bad bugs or drugs, including bringing in only piglets that had been born via cesarean section.

A pristine farm may still not be enough to ensure safe pork. Wallinga of the Institute for Agriculture and Trade Policy notes that it remains unclear just how MRSA got into both the conventional and antibiotic-free retail meat he studied. MRSA may have encountered the pig on the farm, or the microbe may have hitched a ride in the slaughterhouse; at the processing plant; or en route to, or at, the store.

Research even suggests that effluent from sewage treatment plants is introducing antibiotic resistance into the environment that could be picked up by food animals. In other words, humans may well be the original source of the bugs, despite our predilection for blaming the 9 billion or so animals raised for food every year -- and their manure.

Regardless of its origin, debate abounds over just how much danger is posed by MRSA in meat. According to Liz Wagstrom, chief veterinarian for the National Pork Producers Council, that concern is minimal.

Gail Hansen, senior officer with the Pew Campaign on Human Health and Industrial Farming, added, "It's not clear what happens when MRSA is ingested." However, a lot is known about exposure through the blood stream, she said, which is the typical route of infection in the hospital and among livestock handlers such as Kremer.

Even if MRSA doesn't directly make you sick, it can share its lethal information with other bugs in your body, including those that are well-known to cause trouble when consumed, Hansen told HuffPost. Further, many of the resistance genes identified in the NADC study are not typically linked to the antibiotics used in the animals.

"Bacteria are promiscuous with their resistance genes," said Wallinga, highlighting a range of reservoirs of resistance, from manure lagoons to hog CAFOs to sewage treatment plants. "In general, it's not good to have these environments with a lot of bacteria and antibiotics."

Thad Stanton of the U.S. Department of Agriculture, who was involved in both the wild pig and NADC studies, added another wrinkle to the issue: The small physical size of the wild island pigs. "The world would starve if you had to raise feral pigs. We would have to bring in food imports from overseas where there is very little scrutiny," said Stanton. "We need to reach a balance between what is short-term expedient and long-term foolish."

The U.S. Food and Drug Administration issued a draft "Guidance on the Judicious Use of Medically Important Antimicrobial Drugs in Food Producing Animals" in 2010, which offers suggestions to the livestock industry on the prudent use of antibiotics in order to preserve the effectiveness of the drugs for the treatment of human disease. A final version has not yet been released.

Sponsored by Rep. Louise Slaughter (D-N.Y.), the only microbiologist in Congress, the Preservation of Antibiotics for Medical Treatment Act aims higher: the elimination of the non-therapeutic use of antibiotics in livestock. PAMTA was re-introduced in March 2011 after getting buried in Congress in 2007 and 2009.

"We know what to do, it's just a question of the leadership to get it done," Wallinga said.

Meanwhile, the market is spurring some change on its own. "The writing is on the wall," Wallinga told HuffPost. "The farmer that is the early adopter of antibiotic-free production is the farmer that is going to win the future market."

Kremer and the other farmers in his co-op provide pork to rising outlets including Chipotle, Applegate Farms and Whole Foods.

Of course, the consumer also has a major role to play in this line of defense. "'Antibiotic-free' doesn't necessarily mean that the meat is going to be free of antibiotic resistant pathogens," said Tara Smith, an epidemiologist at the University of Iowa College of Public Health and lead researcher on the MRSA study. "Safe handling practices are just as relevant for antibiotic-free raised meats and meats grown conventionally."