The Trouble with Antibiotics (full documentary) | FRONTLINE

Summary

The documentary "The Trouble with Antibiotics" by FRONTLINE investigates the rising threat of antibiotic-resistant superbugs and their links to agricultural practices. It explores the overuse of antibiotics in animal farming and the challenges faced in proving the direct connection to human health issues. Despite being essential for preventing disease in large animal populations, these antibiotics may contribute to the development of drug-resistant bacteria that can affect humans. The program delves into studies and regulatory efforts to address this complex issue, revealing both historical and ongoing debates over antibiotic use in agriculture.

Highlights

• The rising threat of antibiotic-resistant superbugs is linked to agricultural antibiotic use. 🐔
• Investigation reveals farms use antibiotics extensively to boost animal growth. 📈
• Despite efforts, there's still no direct link established between farm antibiotics and human illness. 🤔
• Farmers are not required to report antibiotic usage, complicating tracing efforts. 🔍
• Antibiotic resistance is said to rise wherever antibiotics are used, both in humans and agriculture. 🚜

Key Takeaways

• Antibiotic resistance is a growing problem, with superbugs becoming more common. 🦠
• 70% of antibiotics sold in the U.S. are used in agriculture, not medicine. 🌾
• The FDA tried to regulate antibiotic use on farms in the 1970s but faced pushback. 🏛️
• Recent studies link some drug-resistant infections in humans to farm animals. 🔗
• There's still a lack of conclusive data on antibiotic use in farming. 📊

Overview

Antibiotic resistance is catching up with us faster than ever, as the documentary reveals the unsettling reality of superbugs that no longer bow to the mightiest antibiotics. Destructive and hard to combat, these resistant bacteria flourish around us, partly due to our farming habits rather than medical overuse. As hospitals grapple with untreatable infections, the spotlight turns towards our farms.

From North Georgia's bustling chicken farms to the supermarkets of Flagstaff, the story unfolds of how antibiotics are generously fed to livestock, aiding not just growth but spreading resistance. While farmers aim to prevent disease outbreaks, their methods fuel a hidden risk. Studies show signs of bacteria traveling from farm animals to our grocery aisles, but skepticism remains due to the absence of a direct link.

The government once tried to tackle this issue in the late 1970s but got entangled in political webs. Today, the struggle continues, with new policies leaning on voluntary cooperation instead of stringent regulation. It's a game of data and pressure, with the health of millions hanging in balance as authorities and industries deliberate on the best path forward.

Chapters

• 00:00 - 01:00: Introduction to Antibiotic Resistance The chapter "Introduction to Antibiotic Resistance" explores the rising threat of antibiotic-resistant bacteria, often referred to as "super bugs." It describes how these bacteria are increasingly able to withstand even the strongest antibiotics, posing significant challenges for healthcare and treatment. The chapter is based on a two-year investigation into the emergence and spread of these formidable microorganisms.
• 01:00 - 02:00: Antibiotics in Agriculture The chapter titled 'Antibiotics in Agriculture' discusses the alarming issue of antibiotic-resistant bacteria, commonly referred to as 'super bugs'. These bacteria, including strains known as KPC and NDM-1, have been responsible for significant outbreaks in hospitals nationwide. The chapter highlights the challenges faced by medical professionals as these bacteria continue to spread despite efforts to control them, resulting in more than 20,000 deaths annually due to infections that cannot be treated with existing antibiotics.
• 02:00 - 03:00: Veterinarians and Antibiotic Use This chapter discusses the critical issue of antibiotic overuse and its impact on creating resistant infections, or 'superbugs.' It highlights a significant point that the majority of antibiotics are not used in human medicine but instead are prevalent in other areas, potentially alluding to veterinary use or agriculture, thus adding another layer to the antibiotic resistance problem.
• 03:00 - 04:00: Investigating Antibiotic Resistance The chapter titled 'Investigating Antibiotic Resistance' explores the challenges and secrecy surrounding the use of antibiotics on farms. It mentions the difficulty in gaining access to farms for this purpose. A North Georgia farm allowed access on the condition of anonymity. The farm's veterinarian, Chuck Hofaker, emphasized the crucial role of antibiotics in preventing disease, especially in large-scale farming operations.
• 08:00 - 10:00: Historical Context of Antibiotic Use in Farms The chapter discusses the modern approach of food animal veterinarians who now prioritize preventing the introduction and spread of diseases among livestock. This preventative strategy is emphasized over treating already sick animals, recognizing the scale of operations, such as managing a population of 100,000 chickens, akin to a small city in its complexity.
• 18:00 - 22:00: Government and Industry Challenges The chapter discusses the rapid spread of diseases in populations, similar to an outbreak in a city. The focus is on preventing the spread of sickness, in this case, in chickens due to an intestinal disease. Antibiotics are identified as a means to prevent the disease from spreading, with a specific antibiotic, linky, mentioned as a regular treatment option.
• 22:00 - 28:00: Scientific Research on Antibiotic Resistance This chapter investigates the issue of antibiotic resistance, focusing on how antibiotics are often administered to livestock. It explains the process whereby antibiotics are mixed into the drinking water or feed of healthy animals, typically without a prescription. The chapter describes how antibiotics are introduced to the water supply system before being delivered to animal housing at specific dosages. Moreover, it highlights a staggering statistic that approximately 70% of all antibiotics sold are used in this manner.
• 28:00 - 32:00: Recent Studies and Findings The chapter discusses the benefits of modern farming practices in the United States, specifically focusing on poultry farming. It highlights how chickens drink from automated systems and eat from efficient feeders, leading to healthier chickens and more efficient meat production. This efficiency not only benefits consumers with cheaper and healthier food options but also positively impacts farmers' production rates. However, the chapter concludes by touching upon the rising concern about the widespread use of antibiotics in animal farming.
• 32:00 - 36:00: Regulatory and Industry Response The chapter titled 'Regulatory and Industry Response' delves into the concerns about antibiotic resistance and the potential transmission pathways from chicken farms to humans, specifically the family table. While the possibility of resistance spreading from 'bugs' in chicken houses to people is acknowledged, the frequency of such occurrences is believed to be low. The chapter highlights the challenges scientists face in establishing concrete links between these occurrences and how they have been investigating these connections for a long time.
• 36:00 - 37:00: Concluding Remarks The chapter delved into the investigation of whether antibiotic use on farms is contributing to the growing threat of antibiotic resistance affecting human health. The author encountered complex and surprising new evidence during this inquiry. This investigation led them to Flagstaff, Arizona, where they explored new research efforts on the topic.

The Trouble with Antibiotics (full documentary) | FRONTLINE Transcription

• 00:00 - 00:30 [Music] for the past 2 years I've been investigating the emergence and spread of nightmare bacteria super bugs that are increasingly resistant to even the strongest antibiotics the bacteria are fighting back and they're defeating the drug correct I've been tring the phenomenon
• 00:30 - 01:00 through hospitals around the country where doctors have been dealing with patients infected by these super bugs which go by names like KPC and ndm-1 all these RS mean that the bacteria is resistant to that antibiotic I found outbreaks that have paralyzed some of our best hospitals and no matter what we did the bacteria was still it was still spreading more than 20,000 people a year are dying from the these
• 01:00 - 01:30 infections and as many as 2 million get sick from them what's become apparent is that these nightmare infections are being fueled by the overuse of antibiotics creating bugs we can't kill but the more I looked into it the more I saw there was another dimension to the story it turns out most antibiotics aren't even used by humans
• 01:30 - 02:00 they're used on farms getting onto a farm wasn't easy the use of antibiotics in agriculture has become such a sensitive subject that most Farms won't let cameras in but one in North Georgia agreed as long as we didn't reveal its name what's your big goal the Farms veterinarian Chuck hofaker showed me how antibiotics have become essential to Industrial scale farmer my big goal is to prevent disease and now that's what
• 02:00 - 02:30 almost all food animal veterinarians today focus more on stopping disease introduction preventing diseases from happening rather than having sick chickens and animals that are suffering there's light switch here somewhere I'm looking at trying to prevent any health issues in this small city of chickens of 100,000 it is like a small City isn't it yes because once they get
• 02:30 - 03:00 sick just as in a city the disease can then spread through the population fairly quickly this is what haker wants to prevent this chicken was sick because of an intestinal disease so this is a signal to you that time to use an antibiotic to prevent this from spreading that's correct Chuck what do we have here well this is an antibiotic called linky antibiotics like this are regular
• 03:00 - 03:30 put in the drinking water or added to the feed of healthy animals most of the time without a prescription empty the antibiotic into the into the water water coming out of this bucket with the antibiotic will be injected into their water and then that water will then go on into the chicken house and we'll be at the proper dosage it's estimated that as much as 70% of all anti biotics sold in the
• 03:30 - 04:00 United States go to Farms they drink out of these nipples and they eat from these feeders and that helps the flock grow better the farmer does better because they have more pounds of meat give the consumer a cheaper food supply the chickens are healthier so healthy chickens mean a healthier product for the consumer as well but increasingly this widespread use of antibiotics in animals has been
• 04:00 - 04:30 raising concerns is it possible that there's a pathway I'm thinking particularly of resistance you know could It Go in bugs from the chicken house to The Family Table uh we don't know how often that occurs we think that it probably occurs at a very very low rate um that linkage is very difficult to to connect the dots scientists have long been looking for connections between these dots
• 04:30 - 05:00 trying to understand whether the use of antibiotics on farms is contributing to antibiotic resistance that threatens the health of people as I dug in I began to find new evidence that was complicated and surprising my investigation took me to flagst Arizona where IID heard about some of the newest research being done
• 05:00 - 05:30 flagstaff's hospital has seen a rise in urinary tract infections that are increasingly resistant to antibiotics okay we have the lady in room 12 um she's she came in two days ago with the eoli in her urine right um what came back this morning as being a resistant organism so we had changed from zosin to a carop penum these infections strike an estimated 8 million Americans every year like in Flagstaff dror around the
• 05:30 - 06:00 country are struggling to treat them looks like it's only preliminary but looks like it's a gram negative Rod we're seeing a lot more patients that were previously normally healthy have to be admitted because they've gone through multiple outpatient courses of antibiotics they haven't improved and at the point that they come in that bacteria has gone into their bloodstream and that requires immediate hospitalization you don't have a normally healthy 30-year-old woman come in who's never been in a hospital with a resistant urinary tract infection that's
• 06:00 - 06:30 moved to her blood where did she get that organism from this problem caught the attention of a genetic researcher who had a theory about where some of these infections could be coming from so this is the meat section and this is where our team spent a good part of their year last year buying two packages of every brand of chicken turkey and pork no ex this is chicken I want to get some organic so I'll get two
• 06:30 - 07:00 of these Organics Lance price started sampling the meat Supply in Flagstaff in 2012 trying to figure out if resistant bacteria from farms is ending up on the meat we buy we started the study because we had this hypothesis this theory that food could serve as a source of eoli that then went on to cause urinary tract infections um could I get two l pounds of the ground turkey but could I get it in two separate packages
• 07:00 - 07:30 price isn't concerned with the Trace Amounts of antibiotics that could be in meat he's looking for antibiotic resistant bacteria that could be on the meat and cause dangerous infections if they end up on our hands or kitchen counters or if the meat isn't cooked enough we're producing 9 billion food animals and by using antibiotics in food animal production we're creating drug resistant pathogens that can then go on and cause drug resistant infections and you and me and these guys expired on the sixth all right the problem with urinary
• 07:30 - 08:00 tract infections is that if you get a bladder infection with ecoli and it's antibiotic resistant and the doctor goes to treat you and that treatment fails because the bacteria is resistant then it can get in the kidneys and once it has once it's in your kidneys it has access to your blood right and so then you can get what we call sepsis which kills 40,000 Americans each year hey thanks a lot we're going to put it into broth we're going to put it in the incubator and we're going to see if we can grow ecoli
• 08:00 - 08:30 what price wanted to know is whether the meiles of Flagstaff supermarkets were the source of some of the dangerous urinary tract infections that were showing up in the local hospital his study would take several [Music] years the widespread use of antibiotics on farms goes back decades they were first used on animals in the 1940s among the many valuable new
• 08:30 - 09:00 products created in agricultural Laboratories are mass-- produced antibiotics it was at a time when agriculture was really changing and really becoming much more of a at that time it was not pejorative but it was an industrial model so Farms were getting bigger animals were getting um put closer together when you put the animals closer together and have them confined then it's a lot easier to pass diseases back and forth giving them a little bit of antibiotics sort of seemed to fix that
• 09:00 - 09:30 problem and sort of put a Band-Aid over it anyway but there was another benefit one they had not anticipated the power to promote growth note the weight of a chicken raised for 8 weeks on a regular feed now another chicken nourished for the same period on regular Feed plus pamy a 15% increase in growth they had discovered uh that uh if you add these
• 09:30 - 10:00 drugs to the feed of animals they were very useful in increasing the productivity of the animal they kept them healthy that was the main thing they reduced loss and sicknesses in their animals and they also discovered that it gains the same amount of weight on less feed feed is a very big cost once something special for Sunday dinner chicken inspected and graded is now Thrifty every day people don't realize ize how expensive chicken used
• 10:00 - 10:30 to be so antibiotics helped us get to inexpensive chicken inexpensive and higher quality chicken yes higher quality chicken and pork and beef as well with the help of antibiotics American Meat production has tripled over the last 50 years but with the growth also came concerns as early as the 1960s the British government sounded an alarm in a study called the swan report this was a a milestone report
• 10:30 - 11:00 they said that antibiotics shouldn't be used to get the animals to grow faster because one of the unintended consequences was antibiotic resistance yes it was economically short-term good but in the long term antibiotic resistance was a real problem but the report did not establish a direct link between Farm antibiotics and human illness and that's still the question today I'm not saying that you know the the use in animal agriculture doesn't contribute to to resistance at all of
• 11:00 - 11:30 course we see resistance in veterinary medicine from the use of antibiotics but there's a lot of unknowns as well we really have not shown that direct pathway from um you gave this animal that drug and some person somewhere down the line ate meat from that animal and they now have a resistant infection because you gave that drug way back here and central Pennsylvania I came
• 11:30 - 12:00 across researchers tackling this scientific Challenge in a different way they're trying to track how resistance might travel through the environment from farms to people we came to central Pennsylvania for This research because there were a lot of swine animal feeding operations here Joan Casey is an epidemiology fellow at the University of California at Berkeley 5 years ago when she was studying for her PhD she became interested in antibiotic resistance I'm basically just started
• 12:00 - 12:30 reading about it and trying to find out what was known about antibiotic use and farm animals Casey found research from Europe suggesting that an antibiotic resistant bacteria called Mera which can cause deadly skin infections was traveling from pig farms to people she wanted to know if the same thing was happening here if people living close to huge animal feeding operations were at risk for getting infections from these
• 12:30 - 13:00 operations to try to answer that question Casey turned to Ginger one of central Pennsylvania's largest healthc care providers where she joined forces with Brian Schwarz almost 4 million people live in this region right as a senior researcher he had access to a trove of medical data we're able to get about 160 million electronic records on about 450,000 patients from the region and what did you find Total Mera from 2001
• 13:00 - 13:30 to 2009 straight up wow incidents up every year just a skin infection they found Mera infections had been rising as much as 34% a year in central Pennsylvania and the patients weren't typical people are getting MCA who are not like the ones who used to get it they're not old sick people these are young healthy people and when they compared that data with the location of pig farms in the area a pattern started to emerge this this is the location of where all of the
• 13:30 - 14:00 people with Mera infections live each Red Dot is a person that had a Mera infection so these are all their home addresses right so what I can show you here is the location of the swine operations in this region each of these barns represents a large confined animal feeding operation so let's look at this next one yeah so let me show this to you so what is this so there's some nice overlap you'll between where the merca
• 14:00 - 14:30 cases are and where these large swine Farms are you can see that that there's some people with these infections living very close to animal feeding operations and this is the only study that's really been done in the United States that's looked at rural areas in Mera infection their theory was that the Mera causing some of the infections was coming from pig manure every year in this area there's about 600 million gallons of animal manure spread onto
• 14:30 - 15:00 Fields when you have antibiotics in animal feeds the manure is loaded with undigested antibiotics it's loaded with antibiotic resistant bacteria and it's loaded with the genes that the bacteria can transfer back and forth to each other that allow them to become resistant but help me understand uh how does it get from being put on a field as a fertilizer for crops to threatening me living living in my house
• 15:00 - 15:30 so you put the manure on that crop field and it doesn't rain for a month and the soil gets dusty and a big wind comes by it goes Airborne it can travel by air or conversely a big rainstorm comes by and all the mursa gets washed off into the drainage off of the field and into the local streets and onto the neighbors Lawns we actually found that people living closer to these farms and to the crop field that are located nearby we
• 15:30 - 16:00 about 38% more likely to have a Mera infection than people living farther away right now I think the best hypothesis that we have is that it's coming from industrial agriculture but to the farmers and Drug makers the study was just more unsettled science and speculation well I think the study was very interesting and it uh it showed some associations but I think the implication is that antibiotic use somehow caused the problem and there's no evidence that
• 16:00 - 16:30 that is the case they didn't test any of the manure so they have no data on what was actually in the manure so their study was more speculative than anything why didn't you just take a Trel and and dig up some of that uh crop field where the manure was and test it yourself as part of the study well it cost a lot more money and we didn't have the money for that and you also need permission to go on people's crop fields and in general getting access to uh the uh Farm operations has not been
• 16:30 - 17:00 easy in the end though aren't you really uh speculating about the link based on a pattern we have not made any definitive links but I think there's mounting evidence that there's a problem making sense of the science isn't easy I went to the CDC in Atlanta where they closely track antibiotic resistance is it possible that the use of antibiotics in animals is breeding
• 17:00 - 17:30 resistance that Farms like hospitals are becoming u a place where resistance comes from well it's not only possible I mean it's it's happening I mean we see resistance in pretty much everywhere and everything we test so there is a certain amount of resistance in cattle and and pigs and chickens and humans and the retail meat that we buy in stores anywhere you use antibiotics you're going to you're going to have resistance and propagate resistance
• 17:30 - 18:00 yet the CDC acknowledges the lack of conclusive science it's very challenging to link the use of a particular antibiotic in a particular herd of animals to a particular human illness I mean that is really the challenge so so going from point A to B to C to D to e to F tracing that bacteria all the way to person a with resistance a I mean that that that's that's very challenging to
• 18:00 - 18:30 do because there are lots of steps in between the agency with the authority to regulate antibiotics is the Food and Drug Administration inside their archives I found the story of how the agency tried to reduce the use of farm antibiotics nearly 40 years ago it was 1977 the FDA had a new commissioner a Stanford biologist named Donald Kennedy members of my staff got some documents
• 18:30 - 19:00 to me that convinced me that we really had a difficult problem to deal with livestock had been dosed up just to make the animals put on weight faster one of Kennedy's closest AIDS was Tom grumbly he had passion about this issue almost from the beginning and the way he would express it was look I don't know whether antibiotic resist
• 19:00 - 19:30 is going to come more from the human use of antibiotics or from the animal use but I know that there's really no difference based on the advice of top scientists Kennedy proposed restrictions on two of the most widely used farm antibiotics penicillin and tetracycline he feared that by overusing these drugs farmers were fueling antibiotic resistance and threatening the health of people we're creating in resistant organisms that may ultimately
• 19:30 - 20:00 transfer that resistance to organisms that cause human disease I thought we were doing exactly the right thing the trouble is that you don't always find that as easy as you would hoped opposition to the proposal was immediate Farm lobbies and Industry groups attacked it as theoretical speculation and said it would be financially ruinous one of the most vocal opponents was the animal drug makers group The
• 20:00 - 20:30 Animal Health Institute Ahi was against that at the time do you remember why well I wasn't at Ahi at the time so I don't know and you say that they were but I don't know that they were I mean do you have is there some documents that you've seen there is um this was actually ahi's proposal to to at the time to the docket Ahi said um that the commissioner's proposal is wholly illogical would result in an arbitrary and capricious and thus illegal
• 20:30 - 21:00 regulation I think in the case of penicillin and tetracyclines it was a theoretical concern back then they didn't really have good risk assessment at the time they really couldn't put the whole picture into place as to okay this can happen we know it can happen in the laboratory does it happen in the in the real animal and what is the real risk to Public Health I think that was where they were missing the data the industry turned to their allies in Congress and one of their closest was
• 21:00 - 21:30 Mississippi Congressman Jamie Whitten his informal title was the permanent secretary of agriculture a title he held for several decades Whitten chaired the subcommittee that controlled the entire FDA budget we were at the mercy of Representative Whitten um who basically made it clear that unless we got much more scientific evidence he was going to cut the heck out of the FDA budget so he said that unless you guys would study this and get more information he was going to cut the
• 21:30 - 22:00 budget and that's a pretty serious threat from Whitten right I mean he's a powerful guy that was no threat that was no brag that was truth he would have the proposal was sheld when you proposed this in 1977 it wasn't settled science you said you were confident about it and I just wondered did we know enough I think there was there was a search for what we used to call The
• 22:00 - 22:30 Smoking Gun that is a particular uh antibiotic carried over and so forth I think it was vulnerable enough to the argument that you haven't really shown us the Smoking Gun that that it failed in its time so after you tried and push for this and uh then it got blocked did anything ever happen well it kind of went into the deep freeze uh for a long time you know
• 22:30 - 23:00 people basically just said you know this is in the two hard category um and and until we get uh real evidence or evidence of people I hate to say it dropping in the streets so to speak from antibiotic resistance that nobody's going to do anything about this but there's new evidence emerging that FDA was on to something back in
• 23:00 - 23:30 1977 Morgan hey good morning on a North Texas feed lot introduce I met two veterinarians who have spent years working with the cattle industry guy and I have been working together for last 10 or 12 years on many of these issues actually we've done multiple projects on antibotic Resistance we've been working extensively on this and making progress it's an evolving progress but we're making progress guy lonan of Texas Tech University and Morgan Scott of Texas A&M noticed
• 23:30 - 24:00 something unsettling in their research with cattle an important antibotic called cephalosporin was losing its Effectiveness bacteria were becoming resistant to it so when the cattle got sick they were harder to treat but the scary part was that unlike most Farm antibiotics seyos sporin are critically important to humans too okay they're so critically important because there are certain types of infections um for which they are one of only few
• 24:00 - 24:30 choices available to treat these infections I'll give you one example so clinical sosis in children and and in many cases pregnant females are limited some drug classes can't be used very valuable for children yes yes okay let me grab a bit of dry to try to save seis born for both animals and humans they designed a novel experiment the idea was to use more
• 24:30 - 25:00 tetracycline an older drug less important to people with the hope of reducing resistance to sephos sporin good Mo gu sample right I see so you were hoping to essentially play a little bit of a game here that by using one antibiotic which didn't have big consequences for human health you could preserve and protect one that was important for human health exactly most of the world doesn't care about Tetris cycling resistance they
• 25:00 - 25:30 care a lot about spilus Bor resistance okay so obviously I think you're going to want these and I'm going to want them too the lid should be there in the cuup as well it was cutting edge science but it started with a plastic spoon we collected feal samples directly from the animals and from those feal samples we grew generic eoli we'll put the samples in the cooler ready to send so we're going to ship these down to College Station to do the micro ology
• 25:30 - 26:00 work when they took their samples to the lab they got a big surprise it was like okay this isn't going the way we thought it would we actually saw that resistance went up uh which was not what we hypothesized resistance went up to sephos sporin the drug they were trying to save and this is what the FDA had been worried about in 1977 that the use of tetra cyclings could accelerate the overall spread of antibiotic resist our Viewpoint historically has been that
• 26:00 - 26:30 sure tetracyclin aren't that important for human health so why worry about them in animal agriculture but they may be more important than we think not because of their use in human medicine but because they can expand resistance to critically important drugs we did it for an entire year back in Flagstaff Arizona Lance price was closing in on his search see whether there's eoli in these food foods and whether they have drug resistant
• 26:30 - 27:00 bacteria in them he and his team had spent a year going to supermarkets that's a lot of chicken yeah that's a lot of chicken turkey and pork I think that's it let's go and this is the microlab this is really the heart of our our food operation so we'll first have you gown up here at the lab they've been testing the meet looking for traces of dangerous eoli right so so what they've done is they've taken you know a standard Frozen turkey that and these were actually uh
• 27:00 - 27:30 purchased over Thanksgiving and then culturing the E the bacteria the E coli when we say that there's eoli on a on a turkey product like this we want to know that it's it's definitely eoli and we want to know if it's the Eola that can cause bladder infections or kidney infections or blood infections 20% of the meat they tested had this bad ecoli on it and a third of that was highly resistant so this is an eoli from the food supply and it's resistant to five different antibiotics
• 27:30 - 28:00 so it's resistant resistant resistant resistant resistant so that's five different antibiotics that a physician can't use to treat any E coli infection wow but what price really wanted to know was whether any of this bacteria had caused those urinary tract infections at the Flagstaff hospital this is where we grow bacteria from patient specimens this is a person that has gr negative bacteria so he got the hospital to send him more than 12200 samples of urinary
• 28:00 - 28:30 tract infections they collected from patients so this is this is where we've stored all of the samples that we've collected from this study including thousands from the food supply and thousands from urinary tract infections that we collected at the hospital we have these tubes and we said okay let's look at the DNA from the eoli from the people let's look at the eoli from the the DNA from the eoli and the food supply and say are these matched by using state-of-the-art whole genome
• 28:30 - 29:00 sequencing he compared the samples he got from the hospital with the bacteria he found on Supermarket meat this is all the eoli that we got from food supply and from urinary tract infections and Flag Staff so what the computer's doing right now is it's figuring out how these things are related to one another price is only halfway through his study it has yet to be peer reviewed but he let us in on his preliminary findings so far he says he's genetically linked more than 100 urinary tract
• 29:00 - 29:30 infections back to supermarket meat products and a quarter of them were resistant to several antibiotics Ur for Price this supported his hypothesis that some of the dangerous urinary tract infections were coming from the food supply so here is evidence that these eoli these eoli and the urinary attract infection eoli and the food came from the same original eoli population so probably the farm probably the farm but
• 29:30 - 30:00 you don't really know how it got there right that's a bit of a guess when we see this when we see such genetic relatedness like this the the alternative explanations become you know impossible but even with the high-tech genomics price still can't make all the connections that's because he doesn't have any data on how antibiotics are being used on the farm I was surprised to find out that farmers aren't required to report report how many antibiotics they're using or
• 30:00 - 30:30 for what purpose so we don't even know how many antibiotics are used on turkeys as compared to chickens no we do not and we don't even know really the the volume that's used for humans as compared to animals it's a guess right not really because the data that we have is based on drugs that are being sold not used or how they're used I mean ideally what data would you want to know you're tracking resistance I think we've been clear for for years all of us um meaning
• 30:30 - 31:00 the whole of government academics anyone who's tracking uh foodborn infections that we would like use data to be able to understand resistance and and and and and where it's coming from it's going to help a lot for us to have better use data so that we understand how these antibiotics are being used and where they're being used I mean it's just not available and it's not something that we collect I mean that's not our area as was mentioned you need to talk with
• 31:00 - 31:30 FDA the FDA commissioner is Margaret Hamburg why don't we have that information I mean antibiotics have been used on the farm for four five decades why don't we have it now you know for me the question is can we get it now and that's what we're working on I think it's really it's a question of us all working together to identify what are the critical data
• 31:30 - 32:00 needs and don't you know that now though 40 years I mean shouldn't you have a better handle on that what data you need well I you know there you're asking a very big question in terms of uh the overall picture we are focused on certain aspects of this challenge last year there were proposals in Congress that would have required Farmers to report in detail which
• 32:00 - 32:30 antibiotics they're using on animals and how much but industry groups like The National pork producers Council oppose those efforts did you Lobby against those amendments we the those amendments did not have a lot of support among Congress there was not really a need to actively Lobby against them but you did not want those amendments to be part of that bill we did not think they'd be helpful what to be afraid of with getting more information the people who were asking
• 32:30 - 33:00 for that information are people whose motives were to restrict antibiotic use so you saw this as a way to get restriction not just information correct the proposals died and after years of inaction the FDA tried a new approach last December it asked the pharmaceutical industry to voluntarily stop selling antibiotics that are intended only to make animals grow faster F we actually believe that by taking a voluntary
• 33:00 - 33:30 approach we are going to move towards our goal of getting these antibiotics out of use for growth promotion in a more effective and speedier way than if we actually tried to go drug by drug to pull them from the marketplace the drug makers agreed to phase out these socalled growth promoters over the next 3 years and the FDA will require greater supervision of all antibiotic use by veterinarians industry has told us that
• 33:30 - 34:00 only 12% of the antibiotics that they sell in agriculture are used for growth promotion so does that really mean that 88% of what's being used today will continue to be used the action we're taking is one step but we clearly need a comprehensive strategy in terms of of animal health and and uh Farm practices as well more than being done today oh I think you know we view what we're doing as part of a broader process
• 34:00 - 34:30 I think FDA has is very cautious and because of the history that they had in the 70s where they tried this big step and Congress told them no I think FDA is taking some baby steps I think they could be much Bolder I mean we know what they're going to do they're going to do this voluntary thing right but if they're not collecting the data to verify that people are changing the way they're using using antibiotics that the program is
• 34:30 - 35:00 working you know what's the use how do we evaluate the success of this program without collecting data it's been nearly 40 years since the government first tried to limit the use of antibiotics on farms has anything really changed in those 40 years yeah the use of antibiotics has gone up and C certainly the problem of antibiotic resistance in human beings to
• 35:00 - 35:30 drugs has gone up [Music] substantially we live in a shared environment bacteria that we can find in animals we can find in people and bacteria that we find in people we can find in animals so the route by which they move between them may not be that important but the fact that they move between the two populations is important [Music]
• 35:30 - 36:00 w
• 36:00 - 36:30 for more on this and other Frontline programs visit our website at pbs.org [Music] Frontline front lines the trouble with antibiotics is available on DVD to order visit shop pbs.org or call 1 1800 play PBS front line is also available for
• 36:30 - 37:00 download on iTunes [Music]