Widely acknowledged as one of the greatest health risks of our time, antimicrobial resistance could kills 10s (if not 100s) of millions of people by 2050. Solutions will only come if leaders in the human, animal, and environmental health industries come together. We talked to a couple of those leaders about the collaborative efforts that are underway.
Chief Veterinarian, National Cattlemen’s Beef Association (NCBA)
What do you think is the biggest obstacle facing the industry?
A primary obstacle facing beef cattle producers in the fight against antimicrobial resistance is really rooted in problems surrounding communications, public perceptions, and a significant misunderstanding of the role antibiotics play in our industry.
Cattlemen and cattlewomen are deeply concerned about the development of resistant bacteria in both animal and human populations. America’s beef producers take cattle health, and the safety of beef and beef products very seriously. The role antibiotics play in our industry is important in protecting both animal health and food safety.
Beef producers and their veterinarians have long been committed to practicing the responsible use of antibiotics to treat, prevent, and control animal diseases, while at the same time working to ensure these important products remain effective for future human and veterinary uses. To safeguard human and animal uses of antibiotics, the beef industry has focused its efforts on education and ensuring beef producers understand how and when antibiotics should be utilized in maintaining animal health through the Beef Checkoff-funded Beef Quality Assurance Program (BQA).
Because of its work to combat antimicrobial resistance, the National Cattlemen’s Beef Association was recently recognized by the U.S. Centers for Disease Control (CDC) in the CDC AMR Challenge for achievement in antimicrobial stewardship education through the BQA program. Additionally, the National Cattlemen’s Beef Association is involved in promoting research to combat antimicrobial resistance, and to identify possible alternative agents to antibiotics through work on the Executive Committee of the International Consortium for Antimicrobial Stewardship in Agriculture.
The beef cattle industry has a good story to tell in the work we do daily to foster responsible antimicrobial use practices in all sectors of the industry, and we hope to increase public awareness for our work and to correct any misinformation that currently exists.
What do you believe is one advancement that’s helping combat AMR?
There are a variety of advancements in the beef industry that are helping to combat the spread of antimicrobial resistance and many more on the horizon through active research projects.
Today, producers work closely with their veterinarians to diagnose any potential animal health issues, to minimize disease risks, and to determine the best course of treatment, which all help to reduce the industry’s use of antimicrobial drugs. Looking ahead, perhaps the most exciting future advancements are occuring in the field of genomics, which can allow beef cattle producers to select for cattle that are more genetically resistant to specific diseases, such as bovine respiratory disease, and through significant infectious disease elimination, will further allow America’s beef producers to continue to reduce the use of antibiotics and combat antimicrobial resistance.
Critical thinking is currently taking place in the beef cattle industry for ways to prevent or eliminate disease, and the development of resistant bacteria, with resources currently directed to research in this important area of cattle health.
How do you see the industry changing in the next five to 10 years?
The beef cattle industry has long been a proponent of innovation and has respected the advancements that occur through scientific research and development. There is a great deal of scientific investigation taking place with scientists and veterinarians in the area of genomics and gene editing. By utilizing cutting-edge science, it’s likely that cattlemen and women will have the ability to choose breeding animals that are less susceptible to illnesses and therefore require fewer antibiotics for treatment in the next few years.
As these technologies continue to improve and be adopted more widely by producers, our industry will continue to lessen its use of antibiotics by working to eliminate disease risks. The beef community has already adopted a number of animal health protocols that are helping to mitigate animal health issues, which are both costly and difficult to treat, and, as a result, we’re lessening our use of antimicrobials while also producing more safe, high-quality beef for the market than ever before. That’s a trend I believe will continue to advance rapidly over the course of the next decade and be supported by the beef cattle industry.
Is there anything else you wanted to touch on?
America’s cattlemen and cattlewomen are responsible for producing the safest and most wholesome supply of beef in the world, and part of that work includes ensuring our animals have excellent veterinary care and access to the necessary tools to treat, prevent, and control diseases in cattle. Antibiotics are a primary tool in the fight against infectious diseases in both animals and humans, and must remain as effective agents to combat bacteria.
To ensure the health of our cattle and the continued safety of the beef we produce, we are committed to continuing the fight against antimicrobial resistance both domestically in the United States, through stewardship education, research, and policy work, and internationally, through our efforts in organizations like the World Organization for Animal Health (OIE) and the Codex Alimentarius.
A representative from the National Cattlemen’s Beef Association serves as an active participant on the United States Delegation to both the OIE General Session and the Codex Alimentarius Commission meetings, where antimicrobial resistance issues are addressed at a global level in animals and in food products. We will continue to sponsor international meetings, such as the Second OIE Alternatives to Antibiotics Symposium, that are dedicated to finding innovative solutions to better antimicrobial use and decreased resistance. Working together, beef cattle producers and veterinarians are committed to advancing animal health, promoting food safety, and using antimicrobial drugs responsibly.
Vice President of Research and Global Initiatives, Des Moines University
What do you believe is one advancement that’s helping combat antimicrobial resistance (AMR)?
One important development is novel Antimicrobial Stewardship programs, some that have had considerable recent impact. These have an excellent possibility of being impactful in the future and can be rapidly deployed as a tool we have at our disposal right now.
The concept of Antimicrobial Stewardship is about using antimicrobials responsibly, which involves promoting actions that balance both the individual’s need for appropriate treatment and the longer-term societal need for sustained access to effective therapy. These are typically referring to programs and interventions that aim to optimize antimicrobial use, along with the ability to make adjustments over time.
Although antimicrobial stewardship originated within human healthcare, it is increasingly applied in broader contexts including animal health and One Health.
Another important development that must continue to advance is rapid diagnostics. As rates of drug resistance continue to rise in both Gram positive and Gram-negative organisms, with overlapping risk factors, rapid diagnostics become increasingly important. Rapid diagnostics can be used to both optimize time to appropriate therapy, and also to rapidly de-escalate antimicrobials to avoid use of unnecessary broad-spectrum antimicrobials. These two technologies used in conjunction can be very successful.
There is an ever-increasing need for responsible use to be defined and translated into context-specific and time-specific actions, and this concept exists at the intersection of these two technologies. It is clear that there are marked differences between antimicrobial use paradigms in animal, human, and other industries, and there are significant differences in the resources available to deploy these technologies.
With that knowledge, it is clear that many disciplines must come together, with the support of government and the respective industries involved, to further develop and apply antimicrobial resistance mitigation strategies.
What do you think is the biggest obstacle facing the industry?
It seems evident that the dynamics of antimicrobial resistance genes in bacteria circulating between animals, the environment, and humans is not well understood, and yet continues to emerge. When we contemplate the use of antimicrobials in humans and animals, and the selective pressure by antimicrobials on the respective microbiomes and their associated environments, there is no doubt there is a marked influence.
With that knowledge in place, we must consider the reservoirs that exist in the larger populations on Earth. When we consider some areas in China, recent reports have indicated the prevalence of MRSA has gradually increased from less than 10 percent in the 1980s to 50-70 percent in the 2000s, while the prevalence of ESBL-producing E. coli has increased from 30 percent in 2000 to 60 percent in 2012. In similar data, the class A extended-spectrum β-lactamases genotype constituted 98.1 percent of the of ESBL-producing E. coli being tested in certain regions.