Each year, the CDC estimates that approximately 48 million people get sick, 128,000 are hospitalized, and 3,000 die due to foodborne diseases,1 A report published in the CDC’s Morbidity and Mortality Weekly Report investigated foodborne diseases and the infection trends with pathogens commonly transmitted through food.2
While the incidence of laboratory-confirmed Shiga-toxin producing E. coli O157 and Salmonella serotype Typhimurium infections was significantly lower in 2014 than 2006-2008, the incidence of Campylobacter, Vibrio, and two serotypes of Salmonella infections was higher. What do foodborne illnesses have to do with hospital-based infection prevention? As seen in the chart below3, Norovirus accounts for most U.S. domestically acquired foodborne illnesses – and a fair amount of deaths. With Norovirus, IP departments are called to prevent spread of this easily communicable virus. If there is a real or suspected outbreak, infection preventionists (IPs) can assist the Department of Public Health by updating them as new cases are admitted, helping to put an end to the outbreak.
Another concern for IPs is the antibiotic resistance found in foodborne pathogens. The National Antimicrobial Resistance Monitoring System tracks changes in the antibiotic resistance of certain common foodborne bacteria. In the U.S., resistance in one Salmonella serotype to four drugs (ampicillin, streptomycin, sulfonamides, and tetracycline) rose from 18 percent in 2011 to 46 percent in 2013.4
Patients admitted with a multidrug-resistant organism (MDRO) may have longer hospitalizations and acquire healthcare-associated infections. While hospitals have antimicrobial stewardship programs to assure antibiotics are used judiciously in the hospital and we utilize isolation precautions to prevent transmission of MDROs, hospitals cannot control the amount of antibiotics used in food‐producing animals to treat or prevent illnesses during the weaning period of young animals.
These antibiotics may also be used for long periods at low levels to promote growth, increase feed efficiency, or compensate for unsanitary growing conditions on concentrated animal feeding operations. Many animal producers believe the use of antibiotics for growth promotion also prevents disease.5 It has been estimated that 80% of antibiotics are used in the food-producing animal industry and antibiotic sales to farms rose 16% between 2009-2012.6
What can IPs and pharmacists do? It is difficult enough to stay on top of all of the responsibilities faced daily. Can healthcare organizations be even more proactive in getting involved with the problem of antibiotic use in animal feed?
How has your hospital worked to control foodborne illnesses?
Estimates of foodborne illness in the United States. Retrieved from the internet on August 21, 2015 from http://www.cdc.gov/foodborneburden/index.html
MMWR. Preliminary Incidence and Trends of Infection with Pathogens Transmitted Commonly Through Food — Foodborne Diseases Active Surveillance Network, 10 U.S. Sites, 2006–2014 May 15, 2015 / 64(18);495-499.
CDC Estimates of foodborne illness in the United States. Retrieved from the internet September 9, 2015: http://www.cdc.gov/foodborneburden/estimates-overview.html
Antibiotic Resistance in Foodborne Pathogens is an Ongoing Threat. Retrieved from the internet on August 21, 2015: http://www.infectioncontroltoday.com/news/2015/06/antibiotic-resistance-in-foodborne-pathogens-is-an-ongoing-threat.aspx
Antibiotic Resistance in Foodborne Pathogens. A CSPI White Paper by Caroline Smith DeWaal, J.D., and Susan Vaughn Grooters, M.P.H. May 2013. Retrieved from the internet on August 21, 2015: http://cspinet.org/new/pdf/outbreaks_antibiotic_resistance_in_foodborne_pathogens_2013.pdf
2012 SUMMARY REPORT On Antimicrobials Sold or Distributed for Use in Food-Producing Animals. Food and Drug Administration Department of Health and Human Services September, 2014. Retrieved from the internet on August 21, 2015: http://www.fda.gov/downloads/ForIndustry/UserFees/AnimalDrugUserFeeActADUFA/UCM416983.pdf