UTIs and Chicken

UTIs and Chicken

In a previous article, I discussed how the overuse of antibiotics has resulted in drug-resistant superbugs which are rendering some antibiotics ineffective against bacterial diseases on which they used to work.  Urinary Tract Infections (UTIs) are most commonly caused by strains of Escherichia coli (E. coli) bacteria.

Women (and sometimes men) diagnosed with a UTI used to be treated effectively by some common antibiotics.  But a UTI diagnosis today is a bit more serious than in recent decades.

Prior to the use of antibiotics (which began in the mid-20^th century) a woman’s UTI would either resolve on its own or it could lead to a severe kidney or bladder infection.  If a UTI fails to respond to one or more antibiotics, things can get pretty scary in a hurry.

UTI Cures Are Beginning to Falter

A recent NY Times article entitled: “Urinary Tract Infections Affect Millions. The Cures Are Faltering” states that some standard UTI treatments no longer work.

 The article shares the following three stories that exemplify how a UTI diagnosis has become more challenging for patients and their physicians:

• Carolina Barcelos, 38, a postdoctoral researcher in Berkeley, Calif., said she had several UTIs as a teenager, all successfully treated with Bactrim. When she got one in February, her doctor also prescribed Bactrim, but this time it didn’t work.

Four days later, she returned and got a new prescription, for a drug called nitrofurantoin. It didn’t work either. Her pain worsened, and several days later, there was blood in her urine.

Her doctor prescribed a third drug, ciprofloxacin, the last of the three major front-line medicines, and cultured her urine. The culture showed her infection was susceptible to the new drug, but not the other two.

“Next time,” Dr. Barcelos said, “I’m going to ask them to do a culture right away. For eight days I was taking antibiotics that weren’t working for me.”

• A female patient with a resistant UTI wound up with pyelonephritis, an infection of the kidney, and had to be treated at Highland Hospital in Oakland, California intravenously with a drug called ertapenem that can cost $1,000 per dose. A study found that approximately 5 percent of UTIs at the hospital carried this resistance.
• Dr. Eva Raphael, a primary care physician in San Francisco, recently received notice that one of her patients, a healthy woman in her mid-30s, was back in the emergency room with another UTI that was resistant to multiple antibiotics.

One of her prior UTIs had failed to respond to two commonly used treatments and had spread to her kidney, requiring hospitalization to receive intravenous antibiotics. This time Dr. Raphael consulted with infectious disease specialists.

“It can be quite dangerous in this age where there is more and more resistance,” she said, noting that without effective treatment the infection can get into the blood. “It can be fatal.”

Troubling Research from the US and Great Britain

Research conducted by the NYC Department of Health found that a third of uncomplicated urinary tract infections caused by E. coli were resistant to Bactrim, one of the most widely used drugs, and at least one fifth of them were resistant to five other common treatments.

 Researchers last year reported in a study that a third of all UTIs in Britain are resistant to “key antibiotics.”

The drug ampicillin, once a mainstay for treating the infections, has been abandoned as a gold standard because multiple strains of UTIs are resistant to it. Some urinary tract infections now require treatment with heavy-duty intravenous antibiotics.

Another Reason that Chicken is Not a Health Food

New research shows that one crucial path of transfer of germs that cause UTIs is food, most often poultry. The consumed poultry winds up in a person’s gut and can get transferred through fecal residue to the urethra.

A study published last year by the American Society of Microbiology, funded partly by the C.D.C., found 12 strains of E. coli in poultry that matched widely circulating urinary tract infection strains. One of the study’s authors, Dr. Lee Riley, is working on a C.D.C.-funded project to determine whether the urinary tract infection needs to be classified and reported as a food-borne illness.

Why are UTIs so Commonplace?

It boils down to human anatomy. In women, the urethra is in proximity to the rectum.  This can lead to easy transfer of bacteria in fecal residue that otherwise resides harmlessly in the gut.

In reproductive years, women are 50 times more likely than men to have a UTI.  However, the ratio drops to 2 to 1, as men wind up having surgical procedures on their prostate, or catheters, that more easily expose their urinary tracts to infection.

What’s The Solution?

The solution, researchers and clinicians say, includes a continued push for more judicious use of antibiotics worldwide. But more immediately, a partial solution would be the development of quick, cheap diagnostic tools that would allow an instant urine culture so that a doctor could prescribe the right drug for UTIs.

The Big Chicken Industry is Not Helping

In the US, we’ve known since the 1950’s that soaking chickens in antibiotics resulted in chicken workers developing resistant staph infections.  The United Kingdom (UK) took action in 1971.

In the US, meat and pharmaceutical lobbyists and lawmakers fought regulations and the FDA did not act until 2000 and then, with only one antibiotic. In 2012, it called for the removal of the “growth promotion” indication for antibiotics, but farmers simply now call the use “disease prevention” according to public health experts.

Because these still widely used antibiotics in chicken production are so linked to urinary tract infections (UTIs) in humans, doctors like Lee Riley think UTIs should be called food borne diseases.

Antibiotic use in US chicken production is 3 times higher than the UK and 5 times higher for turkeys, according to a report released by the Alliance to Save our Antibiotics.

A study in BMC Microbiology shows that resistance prevalence was more assocated with brands rather than to product category – meaning that chicken labeled “organic” or “raised without antibiotics” also contained drug-resistant E. Coli.

Eat Less Chicken. 

Avoid chicken. It will mess you up.

But don’t replace it with other meats.  Antibiotics are also used in other factory farmed animals.

Use the recipes on this site. None contain flesh of any kind.

Superbugs Beyond UTIs

Although this article concentrated on resistant bugs that cause UTIs, the continued increase in the number of various drug-resistant  microorganisms is a topic that is largely ignored by mainstream media.

Dr. Matt McCarthy, an infectious disease specialist at WeilI Cornell, is so concerned that he wrote a book called “Superbugs: The Race to Stop an Epidemic”.  It appears that Dr. McCarthy’s concern is justified as the United Nations Interagency Coordination Group on Antimicrobial Resistance states that, by 2050, antibiotic resistance could result in 10 million deaths per year if no action is taken. A report by this group calls out the “misuse and overuse of existing antimicrobials in humans, animals, and plants” for accelerating resistance.

I’ve long been concerned  about the overuse of antimicrobials in humans and animals, but I never stopped to consider the ramifications of antimicrobial overuse on plants.

Anti-fungal agents used on tulips and antibiotics used on oranges are creating resistant strains of pathogenic fungi (molds and yeast) and bacteria.  These resistant strains are often deadly in people with compromised immune systems.

Dr. McCarthy and other infectious disease specialists theorize that the drug resistance of strains of a fungus called  Candida auris (C. auris) is caused by the overuse of anti-fungal agents on many crops such as potatoes, beans, wheat, tomatoes, onions or pretty much any crop you can think of.  A recent NYT article explains why a C.auris infection is particularly frightening.

Dr. McCarthy shares his knowledge and concerns in this 30 minute Medscape interview.

Stay Healthy and Strong