One More Worry as Kids Head Off to College: Superbugs

Choosing classes, managing stress, making friends, finding her passion—that’s a very partial list of my daughter’s worries as she starts her freshman year of college.

A recent piece in The New York Times could add one more: superbug infections. Specifically, the rising number of drug-resistant, hard-to-treat urinary tract infections (UTIs) for which some standard treatments no longer work.

Not long ago, a young woman walking into a clinic with UTI symptoms would have been easy to treat. A simple urine test could confirm the diagnosis. Urine cultures would be unnecessary, the odds being good that E. coli was the culprit. One course of the antibiotic, Bactrim^TM, typically worked well against E. coli, and her pain and burning would quickly disappear.

But a recent study suggests one-in-three UTIs due to E. coli are now resistant to BactrimTM treatment, because those particular bacteria carry genes that make them so. These are just some of the more than 2 million infections each year caused by superbugs of various kinds (aka bacteria resistant to multiple antibiotics) resulting in up to 162,000 deaths. With that impressive figure, superbugs would be the nation's 3rd leading cause of death—more than opioids.

Slowing the spread of superbugs is really quite simple: We’ve got to stop overusing our very limited arsenal of antibiotics in both human medicine and livestock production. Despite decades of warnings, about two-thirds of all antibiotics important to humans are still sold for use in food animals, not people. The vast majority are given en masse to entire flocks or herds via their feed or drinking water. These antibiotics are fed routinely to livestock to compensate for the crowded, stressful, disease-inducing conditions on factory farms, often without regard for whether any sick animals are present. It's a wasteful practice, a practice that squanders these precious medicines even as it fuels the spread of drug-resistant bacteria to people, via contaminated food, manure, air and water.

Why is this a campus concern? Anyone can get a UTI, even babies. Yet the vast majority are in healthy adult women, many of them college-aged, who face higher risks when they are dehydrated, using certain birth control methods, or sexually active—especially with new or frequent partners.

On top of that, one-in-five UTI infections are caused by bacteria that carry resistance to multiple drugs, such that treatment with any of five different antibiotics will fail. Each failed treatment means more pain, suffering, and even hospitalization. Imagine what that might mean for a college student just trying to make it through the semester.

And when common UTIs morph into very serious, drug-resistant kidney infections (pyelonephritis), the IV antibiotics required can run up to $1,000 per dose. For families whose health insurance carries a high deductible, that could blow a very large hole in the already-stretched college budget.

We have seen this problem coming for some time: Nearly two decades ago, the New England Journal of Medicine noted simultaneous outbreaks of Bactrim^TM-resistant UTIs caused by closely-related E coli  strains among college women on campuses across the country . Researchers suspected a contaminated national meat supply was to blame—an explanation supported by subsequent research.Yet, federal policymakers aren’t doing nearly enough to respond to the ever-worsening superbug crisis.

Absent better leadership in Washington, the best bet for positive change may lie with the food industry. Chicken industry research indicates that in a few short years, U.S. producers were able to end the routine use of antibiotics considered medically important by the FDA in more than 90 percent of their operations. Driving that change were antibiotic policy commitments made by many of the nation’s biggest chicken purchasers: McDonald’s, KFC, Chick-fil-A and other major fast food chains.

But bacteria easily share the DNA that makes them drug-resistant, and that resistance also spreads to other species of animals, so the problem must be addressed across the entire meat industry. And with 42 percent of medically important antibiotics sold for animal agriculture going to cows, that means curbing this overuse in beef is a critical piece in solving the antibiotic resistance crisis.

In other words, we need to see fast food chains take the same kind of steps with their burgers as they have with their nuggets. Industry powerhouse McDonald’s recently promised to set targets by 2020 for reducing antibiotic use in 85 percent of its beef supply chains around the world.To kick off the kind of domino effect we saw with the chicken industry, however, we are looking toward another beef industry giant to follow suit: Wendy’s. As one of the nation’s largest beef buyers, Wendy’s owes it to their customers to make a comprehensive, meaningful commitment to end the routine use of medically important antibiotics across all of its beef supplies.

As the worrywart parent of a new college student, I pray my daughter doesn’t become the latest chapter in this evolving superbug crisis. Sadly, it’s inevitable that someone’s child will be. I hope Wendy’s and the American beef industry sees the light, and do their part to prevent that.