Antibiotic Residues in Meat and Meat Products, Implications on Human Health

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Antibiotic Residues in Meat and Meat Products, Implications on Human Health Loinda Rugay Baldrias, DVM, MVS, PhD Dean, Professor College of Veterinary Medicine University of the Philippines Los Banos National Academy of Science and Technology, Philippines (NAST PHL) Roundtable Discussion Livestock Nutritional Biotechnology: Pre and Pro-biotics in Food Animals 11 May 2015, Hotel Jen Manila

Question If you were offered a plate of this delicious lechon, will you accept and serve it to your family? What if you were told that the animal source was treated with a drug before slaughter, would you serve it to your family?

Antibiotic Residues in Meat and Meat Products, Implications on Human Health I. Introduction A. Antibiotic Drugs B. Withdrawal Period C. Antibiotic Drug Residues II. Adverse Effects of Antibiotic Drug Residues A.Toxicological Effects B. Immunological Effects C. Microbiological Effects III. Why do we have Antibiotic residues? IV. What can we do?

Antibiotics Antibiotics substances used to treat and prevent bacterial infection. Have greatly enhanced human life expectancy, reduced mortality, improved the quality of life almost won the war against many infectious diseases.

3-fold Benefits in Use of Antibiotics in Animal Production Producer production efficiency Increasing world population Consumer more affordable, high quality protein Animals improved health (increase feed efficiencies, growth promotion) Advantages disadvantages

Current Animal Management Intensive husbandry Large concentration of animals in confinement Close animal-to-animal contact Less space available Increase risk of disease transmission Mass medication via feed or water Widespread use of antibiotics to control disease & promote growth

In Animal production 1. Therapy of immediate serious disease 2. Prevention of disease to which the animals are likely to be at risk in the future E.g., antibacterials, antifungals, antiparasitic prepn 3. Performance improvement or growth promotion E.g., subtherapeutic doses of antimicrobials 4. Anti-stress medication E.g.,, antibiotics, vitamins, minerals, amino acids, tranquilizers

Antimicrobials given as Feed Additives in Poultry Bacitracin Chlortetracycline Erythromycin Tylosin Neomycin Lincomycin Oxytetracycline Penicillin Streptomycin Virginiamycin Fluoroquinolones Sulfonamides Concentration in Feed: 1-200 g per ton

Concern: Feb. 25, 1989, Philippine Daily Inquirer: DOH Secretary Alfredo Bengzon remarked that veterinarians are abusing antibiotics by making these medicine a regular part of poultry & livestock feeds. Rash pronouncement had big impact/damage to veterinary profession

Drug Residues Antibiotic Drug Residues small amounts that remain in animal products and make their way into the food chain. Withdrawal Periods time between the disappearance of drug s effects and the point at which the drug concentrations in tissues and body fluids reached a certain safe level Varies: Drug used; pharmakokinetics Route of administration Animal species

Antibiotic Drug Residues: HAZARD to Food Safety

Adverse Effects of Antibiotic Residues Toxicological Effects: Dose Related: Acute: high doses = produce immediate toxicity e.g., Streptomycin in pregnant women Damaged cranial nerve and cause congenital deafness e.g., Sulfonamides, Neomycin Damaged to kidney Damage to hearing

Adverse Effects of Antibiotic Drugs Toxicological Effects: Chronic: small doses repeatedly ingested = can build up to toxic level e.g., Tetracylines Discolored teeth, allergic reactions, peripheral blood changes

Adverse Effects of Antibiotic Drugs Immunological Effects: Allergenic residues (haptens) bind with protein forming antigens Symptoms: skin rashes, anaphylactic reaction e.g., Sulfonamides: skin rashes; asthma attacks Chloramphenicol: aplastic anemia

Adverse Effects of Veterinary Drugs Immunological Effects: e.g., Penicillin: 3-10% of pop n hypersensitive; 10 IU (0.6g) can cause allergic reaction 1984: people w/ anaphylactic reaction after eating steak 1972: 2 people w/ anaphylactic reaction after eating pork with 0.02-0.04 ppm penicillin 3/15 developed hypersensitive reaction after drinking milk with 2.5 ug penicillin

Microbiological Effects: Typical Hospital Ward Scenario 1930 s Bacterial infections pneumonia meningitis bacteremia typhoid fever endocarditis mastoiditis syphilis tuberculosis rheumatic fever Use of antibiotics Antibiotic Resistance 1980s Non-infectious conditions cancer heart disease diabetes hypertension 2000s

Microbiological Effects: Eliminate susceptible bacteria leaving resistant ones, alteration in gut microflora Interfere with food processing, e.g., fermented sausages, cheese production

Microbiological Effects: Development of multi-resistant microorganisms Observed association between use of antibiotics in production with development of antibiotic resistance in local Campylobacter jejuni. Detection of antibiotic residues Multi-resistant C. jejuni isolates

Chickens: liver & ceca Commercial producers dressing plant Backyard raisers dressing plant ceca liver

Liver samples for Detection for antibiotic residues

CECA: Isolation of Campylobacter sp. Antibiotic Sensitivity Testing ENRICHMENT & DIRECT methods, Confirmed as C. jejuni by PCR Antibiotic Sensitivity Testing

Chickens tested positive for Antibiotic Residues 64.2% (104/162) positives backyard raisers (39%) > commercial producers (25%) (p<.05) (P-value: 0.0001608) Common use of antibiotics in poultry production

Residue vs Type of Antibiotic Residue least frequent type detected MACROLIDES Resistance Low resistance to Erythromycin (a macrolide)

Antimicrobial profile of C. jejuni isolates: multi-resistance 91.7% (11/12) to cephalothin, ciprofloxacin, colistin, gentamicin, nalidixic acid, sulphamethazine, streptomycin, tetracycline 100% (12/12) to trimethoprim

Antimicrobial resistance profile: 83% (10/12) to ampicillin related to penicillin as most common residue detected 75% (9/12) resistant to chloramphenicol when it is supposed to be banned in food animals? 75% (9/12) resistant to norfloxacin related to use of fluoroquinolones in poultry 33% (4/12) resistant to erythromycin related to macrolides as least detected antibiotic residue

Penicillin residue & cephalothin * Significant (p <0.05) P-values % RESIST- ANCE of Campylobacter jejuni ISOLATES X 2 VALUES FOR TYPE OF ANTIBIOTIC RESIDUE DETECTED Penicillin Tetracyclines Sulfas Aminogly -cosides Macrolides ANTIBIOTIC TESTED Tetracycline Ampicillin 83.3.166.584.584.584.640 residue & erythromycin Cephalothin 91.7.020 *.140.460.140.753 Chloramphenicol 75.0.371.157.157.157.546 Ciprofloxacin 91.7.640.460.140.460.753 Colistin sulphate 91.7.640.460.460.460.753 Erythromycin 33.3.028*.001*.083.030 *.140 Gentamicin 91.7.640.460.460.460.753 Nalidixic Acid 91.7.640.460.140.460.753 Norfloxacin Penicillin 75.0.371 1.00 1.00.157.546 Spectinomycin 66.7.273.083.386.083.460 Suphamethazine residue 91.7 & aminoglycoside.640.460.460.460.753 Streptomycin erythromycin 91.7.640.140.460 residue.460 &.753 Tetracycline 91.7.640.460.140.460.753 Trimethoprim** 100 erythromycin * CO- or CROSS-RESISTANCE bet. DIFFERENT classes of antimicrobials

What is the significance of the statistically observed CO- or CROSS-RESISTANCE? Philippine Generics Law of 1988 = based on Swann Report of 1969 Antibiotics for humans should NOT be used on food animals, e.g., Chloramphenicol banned in food animals Structurally SIMILAR drugs subject to resistance within SAME class of related antibiotics. SIGNIFICANCE: Observed CO- or CROSSresistance shows that resistance to one antibiotic can confer resistance to other structurally DIFFERENT classes of antibiotics

Antibiotic supplementation in Animal production Use of Antimicrobial agents in pro d Dev t of antimicrobial resistance Animal products: meat, milk, eggs Antibiotic Residues e.g., MDR-TB Reservoir of resistant bacteria for human pop n resistant strains restrict treatment options more expensive treatment treatment failure

Antimicrobial Multi-resistance means... People can t be effectively treated people are ill longer & have a higher risk of dying prolonged epidemics greater risk of infection 60% increase mortality due to infectious agents, > 1/2 are resistant increased cost of Tx = U$ 100 M - 10 B hospital cost of managing illnesses by resistant organisms loss of confidence on health industry, pharmaceuticals

True story APRAMYCIN used only in animals due to unusual structure Enterobacteria of animalorigin became resistant to apramycin WHY? due to synthesis of PLASMID-mediated 3-N aminoglycoside acetyltransferase type IV which confers resistance to gentamicin (Chalus-Dancia et al., 1986) Plasmid spread among animal strains Plasmid later found in clinical isolates resistant to gentamicin from hospitalized human patients (Chalus-Dancia et al., 1991) SIG: Spread of resistance involve transfer of antibiotic resistance genes from MO of animals to man

Why do we have Residues?

Why do we have residues? 1. When animal raisers give medication without availing themselves of veterinary services 2. Improper dosing 3. Non-observance of withdrawal period = implied by detection of more animals from backyard raisers to be positive for antimicrobial residues vs commercial raisers

Why do we have residues? 4. Emergency slaughter of treated animals, sale from one farmer to another, then to the slaughterhouse without strict requirement of certification of treatment 5. Intensification of aquaculture, livestock production increasing susceptibility and risk of disease outbreaks 6. Common practice of long-term preventive use of subtherapeutic concentrations of drugs.

Problems 7. Lack of satisfactory data concerning the efficacy & safety of drugs 8. Lack of funding/ interest to gather needed data. Evaluation is a long & tedious process. 9. Little interest in developing and applying for licensing of livestock & poultry drugs

Conclusion What can we do?

What can we do? 1. Promote awareness of producers on importance of reading and observing label instructions on withdrawal requirement of drugs. 2. Promote appreciation of producers/ raisers on adverse effects of improper use of antibiotics

What can we do? 3. Heightened surveillance (through regular mandatory testing) by regulatory agencies for presence of residues. Consumers cannot protect themselves. Residues often tolerate very high cooking temperature. Thus, cooking is not an effective control measure to remove residues in animal products.

Healthy animals = healthy food = healthy consumers

Maraming salamat.

Questions?