Glenda Lewis.

Nelson Mail - - CATALYST -

pre­scribe an­tibi­otics as care­fully and ap­pro­pri­ately as pos­si­ble now. We need to save the big guns in the ar­moury for the bac­te­rial in­fec­tions that really re­quire this ar­tillery.

Rel­a­tive to OECD coun­tries, New Zealand is a low user of an­timi­cro­bials for farm an­i­mals. That is largely be­cause we feed our cat­tle and sheep grass in wide open spa­ces. In sit­u­a­tions where an­i­mals are kept at close quar­ters and un­der­cover (poul­try and pigs), an­tibi­otics are of­ten rou­tinely ad­min­is­tered in feed to pre­vent in­fec­tion and the rapid spread of dis­ease.

Some dairy farm­ers give the whole herd an­tibi­otics to pre­vent mas­ti­tis when they stop milk­ing at the be­gin­ning of win­ter. The New Zealand Ve­teri­nary As­so­ci­a­tion has set a goal to end pro­phy­lac­tic use of an­tibi­otics in an­i­mals by 2030.

Our hu­man/an­i­mal use of an­tibi­otics in terms of to­tal weight of ac­tive com­pound is about 50/50, though the farm an­i­mal pop­u­la­tion is many times greater and cat­tle weigh more than hu­mans and so re­quire more medicine. But it is a con­cern that there is ve­teri­nary use of an­tibi­otics that are vi­tal to treat in­fec­tions seen in hu­mans.

New Zealand is at the wrong end of the OECD ta­ble when it comes to hu­man use of an­tibi­otics. This re­flects our high rate of in­fec­tious dis­ease, which is in­creas­ingly counter to the trend in other coun­tries. This is a con­cern for rea­sons other than an­timi­cro­bial re­sis­tance.

In­fec­tions spread more eas­ily in crowded and un­healthy hous­ing con­di­tions, and among peo­ple who have poor gen­eral health. Doc­tors have been alarmed by the in­ci­dence of rheumatic fever in some ar­eas of the North Is­land.

The most vul­ner­a­ble groups are Maori and Pasi­fika chil­dren and peo­ple four to 19 years old.

Our re­ported in­ci­dence of campy­lobac­ter in­fec­tion is the sec­ond high­est in the OECD (more than 6000 cases a year), de­spite a dra­matic re­duc­tion of food-borne campy­lobac­ter af­ter 2006.

In 2014 a new strain of campy­lobac­ter emerged that is re­sis­tant to two classes of an­tibi­otic. Up un­til that point our rates of re­sis­tance in campy­lobac­ter were ex­tremely low by in­ter­na­tional stan­dards. We need to con­tinue to drive down in­fec­tion rates and re­verse the emer­gence of re­sis­tant strains.

An­i­mal fae­cal mat­ter in­evitably gets into wa­ter­ways and can con­tam­i­nate drink­ing sup­plies with pathogens such as campy­lobac­ter. Chlo­ri­nat­ing drink­ing wa­ter kills pathogens.

Most an­tibi­otics are still ef­fec­tive but tak­ing too many can have ad­verse side-ef­fects.

An­tibi­otics kill ben­e­fi­cial as well as harm­ful bac­te­ria, and re­duce the range of bac­te­ria in our guts.

We are only now be­gin­ning to un­der­stand how im­por­tant bac­te­ria are to our healthy phys­i­cal and men­tal func­tion.

En­vi­ron­men­tal Sci­ence and Re­search (ESR) re­ported that the use of broad-spec­trum peni­cillin al­most dou­bled in the pe­riod 2006-14.

There is no sug­ges­tion that doc­tors or vets should with­hold an­tibi­otics when needed to treat an in­fec­tion. But the choice of medicine needs to be ju­di­cious and care­fully con­sid­ered, and pa­tients need to fol­low health pro­fes­sion­als’ ad­vice.

Sci­en­tists have al­ways known that an­timi­cro­bial re­sis­tance would de­velop. It is how evo­lu­tion works. The ques­tion is how we can buy time while sci­en­tists look for new treat­ments. ESR notes that there are few prospects in the pipeline.

The min­istries of health and pri­mary in­dus­tries have a fiveyear plan to man­age AMR. Part of it is pub­lic aware­ness and ac­tive par­tic­i­pa­tion.

Our first line of de­fence is not to get sick in the first place, and not to in­fect oth­ers. Some gen­eral ad­vice from our Min­istry of Health:

Im­mu­nise against in­fec­tious dis­eases

Wash and dry your hands reg­u­larly and well Stay at home if you are sick Cover coughs and sneezes Clean sur­faces reg­u­larly Prac­tise safe sex

One way that an­timi­cro­bial­re­sis­tant or­gan­isms move be­tween an­i­mals and hu­mans is through the food chain. The NZ Food Safety Sci­ence & Re­search Cen­tre (NZFSSRC) closely watches any food-borne dis­eases and tracks the spread of re­sis­tant or­gan­isms, shar­ing the in­for­ma­tion with sci­en­tists in New Zealand and around the world.

To guard your­self and oth­ers against food-borne in­fec­tion:

Wash and dry your hands be­fore cook­ing and eat­ing, and teach your chil­dren this as well.

An­timi­cro­bial soaps can con­trib­ute to the an­timi­cro­bial re­sis­tance prob­lem, and they are con­sid­ered no more ef­fec­tive than or­di­nary soap and wa­ter.

Han­dle raw chicken care­fully. Store sep­a­rately away from other foods. Don’t let the juices splash and wash ev­ery­thing down thor­oughly. Cook it un­til the juices run clear. Like­wise any minced meat. Wash fruit and veg­eta­bles well. Don’t drink raw milk. It may con­tain E.coli, lis­te­ria, sal­mo­nella or campy­lobac­ter. Heat it un­til just boil­ing (or up to 70 de­grees Cel­sius for one minute) be­fore drink­ing.

Peo­ple work­ing with farm an­i­mals can be in­fected by E.coli, lis­te­ria, tox­o­plasma and lep­tospira. Bugs live on shed floors, an­i­mals, pas­ture, work cloth­ing, and sur­faces in the house. There is a no­tice­able spike in in­fec­tions at calv­ing time. Wash your hands and leave work cloth­ing out­side. Watch the ex­po­sure of small chil­dren who suf­fer from these in­fec­tions more than most. Chil­dren are at much higher risk of in­fec­tion. Healthy an­i­mals and peo­ple can re­sist in­fec­tion. Both need good nu­tri­tion, shel­ter and care.

World An­timi­cro­bial Aware­ness Week is Novem­ber 13-19.

Pro­fes­sor Nigel French is the di­rec­tor of NZFSSRC and a pro­fes­sor of food safety and ve­teri­nary pub­lic health at Massey. Glenda Lewis is a com­mu­ni­ca­tions ad­viser to NZFSSRC

GRANDEDUC

An­tibi­otics kill ben­e­fi­cial as well as harm­ful bac­te­ria, and re­duce the range of bac­te­ria in our guts. We are only now be­gin­ning to un­der­stand how im­por­tant bac­te­ria are to our healthy phys­i­cal and men­tal func­tion.

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