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SAVE THE DATE! International Symposium on Staphylococci and Staphylococcal Infections (ISSSI), 2018, Copenhagen, Denmark

The International Symposium on Staphylococci and Staphylococcal Infections (ISSSI) is highly regarded in the S aureus scientific community. Along with the biannual Gordon Conference and the annual NARSA (Network on Antimicrobial Resistance in Staphylococcus aureus) meeting at NIH, ISSSI is regarded as one of the three major cycling meetings that serve the staphylococcal community. Knowledge on the pathophysiology, treatment, and prevention of this important pathogen has been a topic of exponentially expanding interest both in the United States and abroad. ISSSI has traditionally occurred over several days. Scientific sessions have taken place in the morning and afternoon with evenings reserved for social activities. Poster sessions are available throughout the meeting as is an exhibit area for corporate sponsors. The ISSSI Congress has traditionally sponsored an opening reception, a Gala dinner, and a closing reception.

Recognition of antibiotic resistance as a public health crisis:

  • 2014 and 2015 were good years for worldwide and federal recognition of the increasing threat of antibiotic resistant organisms as a public health crisis. The World Health Organization, the President of the United States and the US Centers for Disease Control and Prevention (CDC) have prioritized this problem and have outlined programs to curtail it. The CDC considers MRSA to be one of the largest public health threats to human medicine.
  • At a global level, in 2014, a report written by the WHO documented that antibiotic resistance was a worldwide public health crisis. The WHO’s Assistant Director-General for Health Security announced "Unless we take significant actions to improve efforts to prevent infections and also change how we produce, prescribe and use antibiotics, the world will lose more and more of these global public health goods and the implications will be devastating."
  • In 2015 the World Health Assembly (WHA) declared antibiotic resistance is the most urgent drug resistance trend and endorsed a global action plan in May 2015 to tackle the problem. To further emphasize the urgency of the issue, the WHA called for the first World Antibiotic Awareness Week from November 16th to 22nd, 2015.
    Source: http://www.who.int/mediacentre/news/releases/2014/amr-report/en/
  • In the United States, the CDC has reported that more than 2 million people were infected with antibiotic-resistant bacteria in a recent year, and over 23,000 people died from these infections. A majority of these deaths can be assumed to be caused by MRSA since a CDC study also reported about 19,000 deaths were due to invasive MRSA infections in a recent year.
  • President Obama signed an Executive Order (September 2014) that initiated Federal efforts to recognize, deal with and discourage the rising trend of antibiotic-resistance. Moreover, the President’s Council of Advisors on Science and Technology made recommendations to address the antibiotic-resistance crisis. To demonstrate commitment, the President proposed to increase the budget in FY 2016 to combat and prevent antibiotic resistance, to nearly $1.2 billion. The President also proclaimed that November 16th through November 22nd, 2015, as Get Smart About Antibiotics Week.

Supermoms Against Superbugs Go To Capitol Hill Again

Moms and pediatricians speak with a USDA representative about antibiotic resistance.
Moms and pediatricians speak with a USDA representative about antibiotic resistance. Everly Macario, at the center of the photograph who lost her 18 month old son Simon to an MRSA infection is an MRSA Research Center "alumna" and is a longstanding advocate of Pews Supermom’s against Superbugs.

Industrial meat and poultry producers feed antibiotics to their animals to make them grow faster and to compensate for overcrowded and unsanitary conditions. These practices are breeding superbugs that make people sick with infections that are harder and costlier to treat. And children, the elderly, and those with weakened immune systems are especially at risk.

Supermoms Against Superbugs, an initiative of the Pew Campaign on Human Health and Industrial Farming, is a movement of moms, dads, grandparents, and other caregivers who want to end the overuse of antibiotics in food animal production. In 2015 Supermoms expanded their attention to advocacy around drug development and human stewardship as well as antibiotic use in livestock.

Antibiotic-free farmers on Capitol Hill
Antibiotic-free farmers on Capitol Hill.
http://www.pewhealth.org/other-resource/supermoms-against-superbugs-85899432655

  • Most of the antibiotics produced in the US (about 80%) are used by factory farms that mass produce most of our nation's meat supply. It is widely thought that such use creates selective pressure promoting a reservoir of antibiotic resistant pathogens that eventually cause human infections that are less treatable due to the resistance. The MRSA Research Center supports legislative efforts at the local and Federal level that would prevent the development of antibiotic resistant pathogens. We support legislation that restricts routine use of subtherapeutic antibiotics for growth promotion and prevention of infection in large concentrated animal feeding operations (CAFOs). In 2014, Susan Boyle-Vavra from the MRSA Research Center was invited by PEW to join a panel of concerned parents, medical and scientific experts, chefs, and public health advocates in Supermom's Against Superbugs to testify before Congress to support passage of PAMTA, PARA and DATA bills. These bills were an attempt to restrict antibiotic misuse on factory farms and to obtain more data about antibiotic use. (See more about Supermom's against Superbugs at: http://www.pewtrusts.org/en/about/news-room/press-releases/2014/04/29/meet-the-2014-supermoms-and-superdads). Supermom’s against Superbugs will be returning to Capitol Hill in February 2016.
  • In 2014 Dr. Boyle-Vavra of the MRSA Research Center testified with a panel of experts before the Chicago City Council to support Alderman Burke’s resolution to support the Federal PAMTA and PARA bills that were introduced to preserve antibiotics by regulating misuse of antibiotics used in raising livestock used for food that promote resistance (See more about these bills below). Chicago joined 49 other U.S. cities in passing the resolution. However, the bills faltered in Congress that year. Thus, in 2015, the bills were reintroduced by Congressional leaders on this issue, such as Rep Louise Slaughter and Senator Dianne Feinstein.
  • The prestigious journal, Proceedings of the National Academy of Sciences (PNAS) published a study in 2015 that estimates that livestock production consumed about 63,151 tons of antimicrobials in 2010 with an expected increase of 67 percent by 2030. In Brazil, Russia, India, China, and South Africa, antimicrobial consumption will increase by 99% due to an increase in demand for animal protein and a shift to mass production in factory-like farms.
    Source: PNAS vol. 112 no. 18, Van Boeckel, 5649–5654, doi: 10.1073/pnas.1503141112.

At least 4 bills and an amendment were introduced in Congress in 2015 that dealt with antibiotics and the FDA passed a Guidance 213. Several bills were introduced that dealt with pathogens in food safety. None of these bills have been passed. The following are noteworthy:

FDA Guidance #213

  • • In 2015, the FDA released guidance #213, a step in the right direction to reduce nontherapeutic and prophylactic uses of antimicrobials in the raising of food animals and to increase the oversight of antibiotic use by veterinarians. This guidance urges animal pharmaceutical companies to voluntarily remove growth-promotion indications from the labels of antimicrobial drugs used in human medicine that would also be used for food-producing animals. It does not, however, apply to prevention of infection among the animals, a possible loophole since the dosages are similar for prevention and growth promotion. The guidance does not provide sanctions if the pharmaceutical industry does not comply. Despite this, many have agreed to cooperate.
    A link to the guidance narrative: http://www.fda.gov/downloads/AnimalVeterinary/GuidanceComplianceEnforcement/GuidanceforIndustry/UCM299624.pdf

Legislative activity in 2015 to preserve antibiotics

Bills introduced in 114th Congress to preserve antibiotics (2015-2016)

1. The Preservation of Antibiotics for Medical Treatment Act (PAMTA)
On March 23, 2015 Rep. Louise Slaughter (D-N.Y.-25), a microbiologist in Congress, reintroduced her signature legislation. This bill seeks to amend the federal Food, Drug, and Cosmetic Act to withdraw licenses for nontherapeutic uses (such as growth promotion) of medically important antimicrobials in healthy food-producing animals. Moreover, new applications for antibiotics to be used in the production of food animals would only be approved for nontherapeutic uses if there were no chance of harm to human health from possible ensuing antimicrobial resistance. Those antibiotics used in animals for food production that could also be used to treat human infections would only be allowed for treatment or prevention of animal disease or infection that is imminent and present on the premises. Rep. Slaughter has been a tireless advocate for promoting prudent use of antibiotics in the raising of livestock. She has been a co-sponsor or sole sponsor of this bill since 1999 and also introduced two other related bills. According to Food Safety News, nearly 450 groups have supported PAMTA including, the World Health Organization, the American Medical Association, the National Academy of Sciences and infectious disease doctors. In contrast, The American Veterinary Medical Association (AVMA) took the official position that it would actively expend resources to prevent the bill from passing (Active Pursuit of Defeat). (http://www.foodsafetynews.com/2013/03/rep-slaughter-reintroduces-pamta-criticizes-fdas-strategy-for-tackling-antibiotic-resistance/#.Vo7M2GhhMk8)
https://www.congress.gov/bill/114th-congress/house-bill/1552?q=%7B%22search%22%3A%5B%22The+Preservation+Antibiotics+for+Medical+Treatment+Act%22%5D%7D&resultIndex=1"

2. Preventing Antibiotic Resistance Act (PARA) S.621.
The PARA bill, reintroduced by Senator Dianne Feinstein (D-CA) on 03/02/2015, amends the Federal Food, Drug, and Cosmetic Act to require the FDA to refuse drug applications if the drug is intended for food animals and is also a medically important antimicrobial in the therapy of human infection and does not meet other criteria including that: the drug is targeted to animals at risk of developing a specific bacterial disease, therapy duration is defined, and there is reasonable certainty that using the drug in animals will not lead to microbial resistance that could later cause harm to humans. This bill will also require the FDA to withdraw approval for specific medically important antimicrobials that are already approved for use in food-producing animals for approved indications if the FDA deems the drug does not meet the criteria of this bill.

PARA was co-sponsored by Senators Kirsten Gillibrand (D-NY) and Elizabeth Warren (D-MA) and has been endorsed by the American Public Health Association, the Infectious Disease Society of America, Trust for America’s Health, the American College of Preventive Medicine and the Pew Charitable Trusts. It was referred to the Committee on Health, Education, Labor, and Pensions but remains stalled.

Source: https://www.congress.gov/bill/114th-congress/senate-bill/621?q=%7B%22search%22%3A%5B%22Antibiotic%22%5D%7D&resultIndex=4

3. Promise for Antibiotics and Therapeutics for Health Act (PATH act).
S.185 Sen. Orrin Hatch [R-UT] (Introduced 01/16/2015). This bill requires drug manufacturers to obtain and provide more detailed information to the FDA on how their antimicrobials are used in food-producing animals. It would also require large-scale producers of poultry and livestock to provide the data to the FDA detailing the type and amount of antibiotics that are contained in the feed given to their animals.

4. Delivering Antimicrobial Transparency in Animals Act (DATA act). HR2459 Introduced in House Rep. Louise Slaughter [D-NY-25] (Introduced 05/19/2015). Would dictate that better information be provided to the FDA and the public about how antibiotics are being used in feed used in animals raised for human consumption. Requires reporting of quantities of antibiotics that are used in each species of food animal and the reason for its use. Better data about antibiotic use in food animals will make it possible to evaluate the effect of phasing out of antibiotics in growth promotion as requested under FDA guidance 213.

5. Reinvigorating Antibiotic and Diagnostic Innovation Act of 2015 H.R.3539. Rep. Boustany, Charles W., Jr. [R-LA-3] (Introduced 09/17/2015). This bill allows for tax credits for 50% of the clinical testing expenses for: (1) infectious disease products that are intended to treat a serious or life-threatening infection, including one caused by an antimicrobial resistant pathogen or a qualifying pathogen listed by the Department of Health and Human Services as having the potential to pose a serious threat to public health; and (2) in-vitro diagnostic devices that identify in less than four hours the presence, concentration, or characteristics of a serious or life-threatening infection.

6. Pathogen Reduction and Testing Reform Act of 2015. Sponsor: Rep. DeLauro, Rosa L. [D-CT-3] (Introduced 05/13/2015) Introduced in The House, this bill seeks to revise the definition of "adulterated" to authorize the Department of Agriculture (USDA) to recall meat, poultry, and egg products that contain microbial pathogens associated with serious illness or death or that are resistant to two or more antibiotics critically important for human medicine. Currently, the USDA has limited authority over what type of bacterially tainted food it is able to recall. The bill also requires USDA to establish sampling protocols and testing procedures necessary to determine if meat, poultry, and egg products are adulterated and to prevent the entry, flow, or movement of those products into commerce.

Fast Food Chain pledges: While the legislative efforts press on, but falter, fast food chains such as McDonalds, Chipotle Mexican Grill, Panera Bread and Chic-Fil-A have pledged to phase in the use of serving poultry raised without antibiotics. Their policies differ in the times to phase in the policy, the species of animal, and the degree of antibiotic exposure to which they denounce. Chic Fil A pledged to do so over 5 years and states it will use chickens that have not ever seen antibiotics, including ionophores. One year after Chic-Fil-A made the pledge, they claim over 20% of their poultry is raised without antibiotics. At McDonald's the use of antibiotics is still allowed for “disease prevention” in the production of its pork and beef, and the company is not transparent as it does not report the percent of poultry raised without antibiotics. Panera Bread and Chipotle Mexican Grill claim they offer several meat options, including pork and beef, produced without the routine use of antibiotics. According to Food Safety News these two establishments received an "A" rating (Sept 2015). Tyson and Perdue, major producers of chicken, have also made pledges to phase down use of antibiotics in raising their poultry.

Source: (http://www.foodsafetynews.com/2015/09/report-ranks-antibiotics-policies-at-fast-food-chains/#.VotXimhhMk8).

SUPERBUG: The Fatal Menace of MRSA

April 27, 2010
Maryn McKenna signing her book

Maryn McKenna signing her book, Superbug, at the University of Chicago MRSA Research Center, April 23, 2010

Medicine disregarded it. Antibiotics can't control it. MRSA — drug-resistant staph — may be the most frightening epidemic since AIDS.

SUPERBUG: The Fatal Menace of MRSA
By Maryn McKenna
Free Press/Simon & Schuster March 2010

To order this book, visit http://www.Superbugthebook.com