Saving Antibiotics: Dr. Lance Price’s Battle with Superbugs

Dr. Lance Price (Photo courtesy Milken Institute School of Public Health)

Imagine a world where strep throat, pneumonia, or even a gash on your shin might prove fatal. That was the world before antibiotics revolutionized medicine about 70 years ago.

Today, these lifesaving drugs are so intertwined into modern medical practices that it’s inconceivable to envision performing surgeries, treating cancer, or even extracting an abscessed tooth without their protection.

But the future of antibiotics is threatened. The overuse and misuse of these lifesaving medicines are creating antibiotic resistant strains of bacteria that reduce or eliminate their efficacy. Part of the problem rests with over-prescription by the medical community. But a significantly larger responsibility lies with the routine, prophylactic use of antibiotics in CAFOs, Concentrated Animal Feeding Operations known as factory farms.

Dr. Lance Price, a leading microbiologist from George Washington University Milken School of Public Health, calls antibiotic resistance one of mankind’s greatest public health threats. At GWU’s Antibiotic Resistance Action Center (ARAC), which Price founded and directs, he studies how “superbugs” become resistant to the drugs we depend upon, tracing their epidemiology and pioneering strategies to block their transmission to humans.

Price especially focuses on the link between antibiotic use in CAFOs and antibiotic resistance and will speak on this relationship during the 2019 JFAN Annual Meeting, Factory Farms Are Creating Superbugs on Thursday, October 24 at the Fairfield Arts and Convention Center.

Price grew up on a Texas ranch and witnessed many changes in agricultural practices over the years. What he saw in antibiotic usage clashed with what he learned about microbiology when in college. “It all seemed so ridiculous,” he says.

Antibiotic resistant infections in the US kill 23,000 people each year, a conservative estimate outlined in a 2013 CDC report. Globally, the numbers are worse, with at least 700,000 people dying from superbugs each year, a number that is predicted to rise to 10 million by 2050 according to a 2016 Review of Antimicrobial Resistance commissioned by the United Kingdom.

Approximately 70% of antibiotics in the United States are used in factory farms, reports the FDA, primarily at low doses to prevent the spread of disease in filthy, bacteria-laden CAFOs. For several decades, scientists had suspected a link between emerging antibiotic resistant bacteria and livestock confinements. Price’s groundbreaking 2012 study tracking data from CAFOs in 19 countries on four continents uncovered smoking gun evidence linking the hog factories to the superbug MRSA – Methicillin-Resistant Staphylococcus Aureus.

Many benign families of Staphylococcus, or Staph bacteria, live on our skin, in our noses, and coat everything we touch, existing harmoniously with humankind—including pig farmers. Some of this Staph is passed innocently from farmers to their swine.

Staph reproduces rapidly and in the process can mutate into resistant strains. Under normal conditions, non-resistant bacteria can overtake and eliminate the resistant strains, but low dose antibiotic consumption in hogs can wipe out too many of the non-resistant bacteria, allowing resistant superbugs like MRSA to emerge.

The pigs can then pass the MRSA back to farmers who may innocently carry the superbug back into the community, risking transmission to those with weakened immune systems or possibly succumbing to an infection themselves. A 2014 Johns Hopkins study found farmers could carry MRSA for up to 14 days.

There is plenty of evidence antibiotic resistant bacteria are making their way out of CAFOs. A 2013 Johns Hopkins study found that 11% of MRSA and soft tissue infections were found in individuals living next to fields where liquid hog waste was applied. A 2014 University of Iowa study revealed that people living within a mile of a 2500-head factory farm were nearly three times more likely to colonize—or carry—MRSA. Then a Texas Tech study published in 2015 found wind was blowing feedlot dust carrying antibiotic-resistant bacteria DNA into surrounding communities.

Consumers are also bringing antibiotic-resistant bacteria into their homes from grocery stores. A multi-center team study led by Price and published in 2018 identified a strain of E. coli on poultry meat that causes urinary tract infections in people. The particular strain, E. coli ST 131, is particularly adept at traveling from the bladder to the kidneys and blood, and kills thousands of people in the US every year.

Now Price’s team is looking at all E. coli strains to determine what proportion of UTIs may be caused by foodborne E. coli.

In addition to leading groundbreaking studies, Price and ARAC also advocate for science-based policy changes with nongovernment organizations and policy makers. In 2014 he testified before the White House Office of Science and Technology Policy during the Obama Administration, urging lawmakers to curb the use of antibiotics in agriculture and medicine. It resulted in a National Action Plan, largely symbolic.

The FDA did implement a voluntary guidance in 2013 to eliminate antibiotics for growth promotion, which is largely followed, Price says, but which contains a loophole. “There’s a very thin line between growth promotion and disease prevention, he says, “and veterinarians [that write the prescriptions] are employed by the hog corporations.”

Nonetheless, Price and ARAC continue to lead the way to preserve these precious drugs, focusing on out-of-the box solutions to antibiotic resistance. Several studies show emerging resistance can be reversed by curbing antibiotic overuse.

“If we can dial back the use of antibiotics in animals, we can slow the evolution of resistant strains,” Price says.

Diane Rosenberg is the President and Executive Director of Jefferson County Farmers & Neighbors, Inc.