Farm to Bedside: Antimicrobial Resistance in Agriculture and its Effect on Humans

Vaccine and Infectious Disease Division

Farm to Bedside

Antimicrobial Resistance in Agriculture and its Effect on Humans

By Ashley Sherrid, Infectious Disease Sciences Technical Editor | Jan. 23, 2018

On Thursday, January 25th, at 3:30 PM in Pelton Auditorium, Fred Hutch will host, “Farm to Bedside: Antimicrobial Resistance in Agriculture and its Effect on Humans.” Take advantage of the rare opportunity to hear about antibiotic resistance from investigative journalist and author Maryn McKenna, as well as five leading local experts who will take part in a panel discussion. Antibiotic resistance is a growing, global issue – and it threatens to limit the ability of doctors to perform surgery, combat infections, and protect and treat major at-risk populations such as individuals with cancer. “I think of antibiotic resistance as one of the most dangerous risks to modern healthcare,” said Dr. Steve Pergam, the Medical Director of Infection Prevention at Seattle Cancer Care Alliance, who will co-chair the event.

Historically, our development of new antibiotics has barely outpaced the generation of resistance by bacteria – and now some types of bacteria have caught up. Without effective antibiotics, we will lose the power to protect patients undergoing cancer treatment, to treat simple infections like strep throat, or to do routine surgery such as removing an appendix or replacing a knee. “We’ll be going back in time instead of forward,” said Pergam. Currently, over 2 million Americans become infected by antibiotic resistant bacteria annually, and some projections estimate that antibiotic resistance could cause 10 million deaths globally by 2050. Making such predictions comes with certain challenges, but it is certain that the changes we make now will affect the scale of this problem in the future.

Maryn McKenna

Maryn McKenna, author of the new and acclaimed book “Big Chicken: The Incredible Story of How Antibiotics Created Modern Agriculture and Changed the Way the World Eats,” will lead off the event by speaking about the history of agriculture’s role in the emergence of drug resistance. After McKenna’s talk, the panel of regional experts on antibiotic resistance will discuss the practical ramifications of this crisis for our food supply and how hospitals play an important role in developing resistance. Topics discussed will include potential effects on the health of patients (particularly cancer patients, who are at increased risk for infections), mechanisms by which resistance is linked between animals and human disease, and the idea of a “one health” approach (which considers humans, animals and the environment in developing tools to prevent the spread of infections and antibiotic resistance). 

Big Chicken

Maryn McKenna’s newest book provides a riveting and immersive look at how antibiotics enabled the rise of modern agriculture, how agricultural antibiotic use has contributed to the rise of antibiotic resistance, and the effects of antibiotic resistance on both how we eat and how we cure common infections. McKenna’s book paints the picture of how antibiotic resistance has developed, and how individual farmers and whole nations are taking steps to protect antibiotics. These changes do not come easily; there is political, economic, and cultural opposition to modifying standard practices of modern agriculture. Use of antibiotics to prevent and treat disease, and even to promote growth, has become standard practice – but examples from McKenna’s book suggest that it is possible to decrease agricultural antibiotic use without sacrificing quality standards or the ability to make a profit. However, lasting success will depend on how we work together to handle antibiotic use in agriculture, and how widely these policies are adopted. 

Antibiotic Stewardship – Preserving Antibiotic Effectiveness in the Clinic

Medical Directors of Antimicrobial Stewardship, such as Dr. Catherine Liu of the Seattle Cancer Care Alliance, Dr. Paul Pottinger of UW Medical Center, and Dr. Scott Weissman of Seattle Children’s Hospital, tackle antibiotic resistance as it affects human medicine. They are in charge of identifying and implementing policies to hinder the rise of antibiotic resistance, while maintaining the highest standards of clinical care. Asked about the effect of resistance on patient care, Liu said, “Antibiotic resistant infections are more difficult and sometimes impossible to treat. This makes it harder to take care of our patients, especially those with weakened immune systems. We need to use antibiotics wisely to ensure that these powerful drugs are effective for our patients now and generations to come.” Dr. Liu’s research aims to identify policies that improve patient outcomes by tailoring antibiotic use correctly to each patient. Liu and Weissman will be panelists, and Pottinger will co-chair the event.

Tracking the Spread of Resistance

To develop successful policies for controlling the spread of antibiotic resistance, we need quality data on how it spreads in the first place. This is an area of intense, active research, and several of our panelists are in the thick of it. Dr. Douglas Call, Associate Director of the Paul G. Allen School of Global Animal Health at Washington State University, identifies factors that contribute to emergence, amplification, and dissemination of antibiotic resistance in food animal production systems. Call’s group has identified agricultural practices that can propagate antibiotic resistance, and is interested in developing tailored solutions to reduce its spread. Dr. Scott Weissman’s research focuses on resistance at the molecular level, tracking resistant strains and plasmids (bits of resistance-enabling DNA that bacteria can pass back and forth) as they spread among individuals, and across continents.

Marisa D'Angeli, a Medical Epidemiologist at the Washington State Department of Health (DOH), is involved in complimentary work to track and combat antibiotic resistance. D’Angeli leads the Combating Antibiotic Resistance Initiative for the DOH, and coordinates surveillance of Enterobacteriaceae resistant to carbapenems, a class of antibiotics considered to be the most reliable last-resort treatment for bacterial infections.

One Health – An Interconnected View of Animal, Human, and Environmental Health

The threat of antibiotic resistance underscores the interconnectedness of humans, animals, and our environments. Antibiotic use in each of these spheres affects the others. This idea is central to the mission of the Center for One Health Research at UW, directed by Dr. Peter Rabinowitz, who is also a Professor in Environmental and Occupational Health Sciences and Global Health at UW. The Center focuses on linkages between human, animal, and environmental health in a "One Health" paradigm. Dr. Rabinowitz and colleagues at the Center aim to improve antibiotic stewardship associated with the care of both humans and animals, by fostering collaboration between veterinarians and physicians.

Thursday’s panel is distinctive in that it will feature five researchers and health professionals who are not only some of the leading experts on antimicrobial resistance, but also are leaders who are in positions capable of actually making changes and setting new policies to curb this modern threat. Of the panel, Pergam said, “We hope people who come to this will get an idea of the challenges, controversies, and possible solutions,” surrounding antibiotic resistance in the modern era. The event is free and open to the public, but registration is required for entry at Fred Hutch. Please RSVP. Contact us at IDAdmin@fredhutch.org with any questions.