back                                                                  MYTH # 4
The Spread of Antibiotic Resistance is Caused by the Over Use of Drugs by Doctors and in Agriculture
                                                     A Short History Lesson
                     
A PERFECT STORM OF ANTIBIOTIC RESISTANCE

             “A common misconception is that science and research are about facts.”
                    (Chris Griffith, editor, British Food Journal 2006 Vol 108 Issue 8)

    Antibiotic resistant "Pathogens in sewage sludge pose a disease risk only if there are
    routes by which the pathogens are brought into contact with humans or animals."
    (Engineers Steve Arant and Greg Kester)
    http://www.wwoa-cwea.org/eco-letter/eco_wntr_02.pdf

Jim Bynum, vp                                                                                                                                  Revised 11/18/2011
Help for Sewage Victims

Edited by Gail Bynum, Ph.D

Back to Index sludge myths                                                                                               

Introduction ---------------------------------------------------------------------------------------------------------------------------------- 1
Basic Antibiotic Resistance History ------------------------------------------------------------------------------------------------------ 7
Drug and Antibiotic Resistance -----------------------------------------------------------------------------------------------------------11
Viable, but nonculturable to Antibiotic Resistant Synthetic Biology ----------------------------------------------------------------13
Antibiotic Resistance in the Soil.----------------------------------------------------------------------------------------------------------16
Laboratories/Antibiotic Resistant Bacteria -------------------------------------------------------------------------------------- ------ 26
Antibiotic Resistance in Hospitals--------------------------- ---------------------------------------------------------------------------- 37
Chlorine/Antibiotic Resistance in Bacteria --------------------------------------------------------------------------------------------  50
Metals/Antibiotic Resistance in Bacteria ---------------------------------------- ------------------------------------------------------- 61
Ultraviolet (UV) Radiation/Antibiotic Resistance in Bacteria ------------------------------------------------------------------------ 72
Antibiotics Resistance in Sewage Wastewater Treatment Plants------------------------------------------------------------------ 77
Antibiotic Resistance in Water  ---------------------------------------------------------------------------------------------------------- 92
Antibiotic Resistance in “Biotech” plants----------------------------------------------------------------------------------------------- 104
Antibiotic Resistance in Animals and Birds --------------------------------------------------------------------------------------------108
Antibiotic Resistance in Agricultural Products ---------------------------------------------------------------------------------------- 112
Conclusion---------------------------------------------------------------------------------- -----------------------------------------------   117


Introduction

We have been creating a perfect storm of new intergeneric antibiotic resistant microorganisms in the environment over
the past thirty years, or as EPA described them, new chemical substances. There are so many genetically modified
organisms, both natural and engineered, that have become pathogens as well as antibiotic resistant that doctors have
no idea what they are treating in many cases. Even well equipped laboratories may not be able to readily identify the
specific strain of bacteria.

Apparently, few realize that antibiotics are produced by soil organisms and  resistance has always been a natural
phenomenon among plant and soil bacteria.  Drugs prescribed by doctors have only contributed a minor portion of the
spreading drug and antibiotic resistance problem.  Another contributing factor is the use of antiseptic and disinfectants
which also create resistant bacterial  strains.  That  market is currently at 3.8 billion, but expected to reach $7.1 billion in
2016, because of claims that antiseptics and disinfectants kill 99.99% of the exposed bacteria. Genetic engineering of
chimera bacteria that could not naturally exist in nature is a major contributing factor. The final step is mixing the medical
and laboratory resistant strains with chemicals and metals resistant strains in sewage treatment plants where they are
exposed to disinfectants such as chlorine and UV radiation creating additionally more virulent chimera bacteria which
are released in “treated” sewage effluents and sludge. Agricultural use of drugs and antibiotics in animals has been a
reaction to the spreading of human and animal pathogenic bacteria in the environment through the disposal of
contaminated sewage effluent for irrigation and sewage sludge as a fertilizer on grazing land, crop land as well as on
orchards and gardens.

The real problem is the mixing of human and animal pathogens with naturally occurring antibiotic resistant soil bacteria
where they may swap DNA. While human and animal pathogens may pick up antibiotic resistant DNA from soil bacteria,
soil bacteria may also pick up human and animal virulent DNA, thereby becoming human antibiotic resistant pathogens.  
The best advise government experts have to protect public health from the following family of bacteria is to wash your
hands. The experts claim this family of bacteria generally don't cause disease, which is true, if you are not exposed.

The
Enterobacteriacea family of gram negative bacteria  is an example of the changing nature of antibiotic resistant
pathogens that may be airborne, foodborne and waterborne.  Twenty-five years ago only gram positive
Clostridium
perfringens (formerly known as Clostridium welchii),
Streptococcus and  Staphylococcus were involved in “soft-tissue
infections” better known as
necrotizing "flesh eating"  infections. Now, many of the gram negative Enterobacteriacea
family of “coliform” have pick up the genes causing  necrotizing "flesh eating"  infections,  including well known members
of this enteric pathogen family such as:  
E. coli; Klebsiella; Citrobacter; Enterobacter;  Shigella; Salmonella; and Yersinia
as well as less known families such as,
Averyella; Budvicia aquatica; Buttiauxella noackiae; Calymmatobacterium;
Cedecea; Edwardsiella; Ewingella; Hafnia alvei; Kluyvera; Koserella; Leclercia adecarboxylata; Leminorella; Moellerella
wisconsensis; Morganella; Pantoea; Photorhabdus; Proteus; Providencia; Rahnella aquatilis; Serratia; Tatumella;
Xenorhabdus; and Yokenella regensburgei. This group is unique in that low levels of disinfectants and heat above
104°F cause cell injury and stress, throwing the bacteria into a temporary inactive mode. The exception is that
thermotolerant (fecal coliform) E. coli, Klebsiella, Citrobacter and Enterobacter will generally show some minor activity at
112.1°F.

These gram negative bacteria caused 40% of the 1.7 million health care acquired infections in 2002 which resulted in
98,987 deaths. Causes of death for the 98,987 were 35,967 for pneumonia, 30,665 for bloodstream infections, 13,088
for urinary tract infections, 8,205 for surgical site infections, and 11,062 for infections of other sites. Community-
acquired infection data is harder to come by for other types of   bacteria, except for hospital stays with methicillin-
resistant
Staphylococcus aureus (MRSA) infections between 1993 and 2005. Hospital stays for MRSA exploded from
1,900 in 1993 to 368,300 in 2005. Approximately one infection out of 20 caused extremely painful death (18,000-
19,000) from necrotizing fasciitis (i.e. flesh-eating bacteria syndrome).  Necrotizing fasciitis is a progressive soft tissue
infection in which the cells actually die. The only way to stop it, if you are lucky, is to surgical remove the infected flesh. It
doesn't always work as my friend discovered, as she lost one leg and then the other, before it finally took her life.

State and federal regulators and associated industry spokespersons claim some magical sewage treatment process will
protect  you from exposure to drug and antibiotic resistant disease causing mesophilic pathogens in sewage effluent,
sludge and drinking water. That same magic extends to the term biosolids which the industry spokespersons likes to use
instead of sludge. As it was shown in  “
MYTH # 3, Coliforms Are Non-pathogenic Indicators of Sewage Fecal Pollution in
Food, Water and Sludge,” the magic is in the terms, and the tests, used to hide the truth. Based on the  documents, it is
the scientific consensus that mesophilic E. coli, the primary member of the pathogenic Enterobacteriacea family, is not a
pathogenic microbe when tested at 98°F and it only confirms human fecal contamination if some minor E, coli growth
activity occurs at an elevated  temperature of 112.1°F.

Optimum growth of mesophilic bacteria is between 70°F to 90°F, but they go into a survival mode at temperatures above
and below (40°F to 70°F, and 90°F to 110°F). To put this in perspective, antibiotic resistant mesophilic E. coli may be a
fecal pollution indicator coliform which is allowed in 5% of drinking water tests or a fecal coliform which is not allowed in
drinking water.  Coliform is a working definition used to describe the
Enterobacteriacea group of Gram-negative,
facultative anaerobic rod-shaped bacteria that ferments lactose to produce acid and gas within 48 h at 35°C (95°F).
Fecal coliform tests are done at 45.5°C for food testing, except for water, shellfish and shellfish harvest water, drinking
water, sewage effluent and sewage sludge testing, which use 44.5°C  (112.1°F). That is a temperature that few humans
or pathogenic bacteria could survive for 24-48 hours in a viable condition. However, in 1977, A.W.Halley, Bernard J.
Dutka reported in “
Bacterial Indicators: Health Hazards Associated With Water,” that of the fecal coliform temperature
survivors in the treatment plant,
E. coli only makes up about a third to a fourth of the bacteria. The other 3/4 is 25%
Klebsiella and 50% Enterobacter-Citrobacter. These four microbes are a major causes of hospital acquired antibiotic
resistant infections.  
http://books.google.com/books?
hl=en&lr=&id=GCWL5nlC7TEC&oi=fnd&pg=PA48&dq=fecal+coliform+influent&ots=AuSkWrBgkh&sig=

The implication is that the gram negative lactose fermenting vegetable type thermotolerant (fecal coliform) E. coli,
Klebsiella, Enterobacter and Citrobacter are something other than pathogenic coliform and the only bacteria of concern
in sewage. Other gram negative and gram positive pathogenic bacteria that infect humans at 98.6°F or below do not
show up in the fecal coliform test. Another confusing aspect is that there were few, if any, lactose fermenting Salmonella
in the coliform family in 1977. Not only that, but E.coli 0157:H7 with the Centeral American Shigella toxin gene had not
yet been identified. The industry does a very good job of confusing the public, especially when it explains how sludge is
changed to biosolds. Not only that, but the experts imply that pathogens are not microbes such as bacteria, viruses,
helminths and parasites. As an example, the Orange County, CA, Sanitation District explains how sludge digestion is
accomplished. The website states, “The solids are held in giant “crockpots” for approximately 20 days at 98 degrees
Fahrenheit, which allows microbes to digest the sewage solids and create biosolids. This digestion process is a way of
“reverse engineering” the process of digestion in our own bodies; in this case we are removing the pathogens with the
help of microbes. As with our own bodies, the digesters also create gas. Fortunately, we can capture and scrub the
biogas in order to use it onsite in large generation facilities and fuel a significant portion of our treatment plants’
electricity needs.”
http://www.ocsd.com/news/displaynews.asp?NewsID=703&TargetID=12

Yet, these experts don't consider pathogenic microbes to be a problem unless they find some minor activity in tests
done at 112.1 degrees Fahrenheit. As will be illustrated by the studies, treatment plants are a swap meet for exchanging
antibiotic resistant DNA. A higher percentage of antibiotic resistant bacteria are released to the environment than
entered the wastewater and drinking water treatment plants. All pathogenic antibiotic resistant microbes that infect the
body do so at about  98 degrees Fahrenheit, not at 112.1 degrees Fahrenheit as recommended by EPA for testing. As
was  pointed out in “
MYTH # 2, Composted Sewage Sludge (biosolids) is a Safe and Sustainable Organic Soil
Amendment!”, those pathogens that were “removed” may still be viable but nonculturable because of stress, or a lack of
nutrients, by standard laboratory methods. They may show up a year later when nutrients, moisture and temperature
allow them to reactivate.

Most people who promote the scientific myth that antibiotic and drug resistance are caused by over use of antibiotics
and drugs by doctors, as well as overuse in agriculture, have good intentions, but little background in the subject. They
appear to assume that just because antibiotic resistant bacteria appear where antibiotics from bacteria and fungi or
synthetic drugs are used, then this must be the source of the problem.  Few people recognize that antibiotic resistant
soil bacteria are a natural phenomenon induced by other antibiotic-producing organisms as well as in our efforts to
control them.

The reality is that experts have been so busy trying sell us products to protect us from exposure to bacteria and viruses
that we are becoming paranoid and creating more antibiotic resistant bacteria. We buy products that claim to kill 99.99%
of the bacteria. What they don't tell is that the remaining viable bacteria are resistant to the product. Not only that, but
many bacteria are only injured, which takes several days for the
bacterial cell self-repair mechanism to work. But even if
it were true 99.99% of the bacteria were killed today, tomorrow the survivor's resistant to the product could multiply to
the original level of bacteria with complete immunity and feed on the product.

What we can not control is the genetic engineering laboratories where antibiotic resistant genes are deliberately
inserted into bacteria (sometimes using viruses) to confirm transfer of other genetic material. Unfortunately, all of these
antibiotic resistant bacteria and viruses will find their way into the sewer, then work their way through a sewage
treatment plant to contaminate other bacteria and viruses as well as our food, water and soil.  

As early as 1974, studies show
coliforms (Enterobacteriacea family incubated at 95 degree F.) were resistant to
antibiotics and metals in the sewage sludge Ocean Dumping Area known as the New York Bight. The bacteria were
shown to transfer antibiotic resistance during conjugation (horizontal transfer). Yet, knowing all of the above, EPA, FDA
and USDA created the 1981 Federal Policy “Land Application of Municipal Sewage Sludge For The Production of  Fruits
and Vegetables, A Statement of Federal Policy and Guidance.” The policy "recognizes that pathogen survival is greater
in warm, moist environments, than in extremely arid or colder environments – [and the] –  government can not offer any
indemnity against product recall, seizure, or other enforcement actions.” http://thewatchers.us/EPA/1981-policy-EPA-
USDA-FDA.pdf

It is easy enough for the average person to believe the scientific myth that misuse and overuse of drugs are responsible
for the dramatic spread of antibiotic resistance. After all, the government, the medical profession, and the media are
claiming it is true. Part of the current belief may be traced back to M. Demerec, Department of Genetics, Carnegie
Institution of Washington, who offered evidence in 1948 that bacterial resistance is a natural phenomenon. He said, “...
bacterial resistance to penicillin and streptomycin is not induced by these compounds but originates spontaneously
through genetic changes comparable to gene mutations.”

While Demerec mistakenly thought bacteria would not develop resistance to penicillin, he said, “ In treatment with
streptomycin, however, the development of highly resistant strains cannot be prevented; effective treatment does not
eliminate all bacteria, but it probably reduces their number to a level at which the organism is able to eliminate them.”
What Demerec and others discovered was that while antibiotics killed some bacteria in a laboratory petri dish, there
were some of the same bacterial  mutants that thrived on the antibiotic. What is most disturbing to me is Demerec's use
of the term organism for humans.  When researchers, politicians and regulatory experts began thinking of us as
organisms, we lose our humanity. Now we are just another organism for  researchers, politicians and regulatory experts
to experiment with.

The current regulatory experiment follows a pattern: 1) Resistance is a self-defense reaction to environmental toxins,
both natural  and manmade, such as metals, microorganism toxins-antibiotics, disinfectants, and other toxic chemicals;
2) Researchers have been creating new antibiotic resistant organisms in the laboratory for over 60 years; 3) Teachers
are now teaching high school students how to create new antibiotic resistant bacteria in the class room; 4) Drugs,
metals, calcium chloride and toxic chemicals are released to sewage treatment plants; 5) Antibiotic resistant organisms
and viruses are released to sewage treatment plants where calcium chloride promotes Conjugation, Transduction and
Transformation as “bacteria treat” the sewage; and 6) Engineers and experts then promote the release of antibiotic
resistant bacteria from sewage treatment plants in treated sewage effluent released to surface water, as sewage effluent
(reclaimed water) used on crops and lawns and treated sewage sludge (biosolids) used as a fertilizer for  fruits and
vegetables, on grazing lands, parks, school grounds, home lawns and gardens.

There seems to be a simple solution to preventing much of the spreading antibiotic resistance in the community. A good
start on preventing antibiotic resistance in the community is to stop putting antibiotic resistant genes in genetically
modified organisms (GMOs), stop disposing of laboratory created GMOs into the sewer, and most importantly, for
federal agencies to quit promoting treated GMO and metals contaminated water and sludge on grazing land, foodcrops,
parks, school grounds, home lawns and gardens.

The federal agencies responsible for this disaster did develop a plan to address antibiotic resistance. However, the
focus is on restricting antibiotic use in “A Public Health Action Plan to Combat Antimicrobial Resistance.”In the Executive
Summary, they said, “This Public Health Action Plan to Combat Antimicrobial Resistance (Action Plan) was developed by
an interagency Task Force on Antimicrobial Resistance that was created in 1999. The Task Force is co-chaired by the
Centers for Disease Control and Prevention, the Food and Drug Administration, and the National Institutes of Health and
also includes the Agency for Healthcare Research and Quality, the Health Care Financing Administration, the Health
Resources and Services Administration, the Department of Agriculture, the Department of Defense, the Department of
Veterans Affairs, and the Environmental Protection Agency. The Action Plan reflects a broad-based consensus of
federal agencies on actions needed to address antimicrobial (a) resistance (AR). Input from state and local health
agencies, universities, professional societies, pharmaceutical companies, health care delivery organizations, agricultural
producers, consumer groups, and other members of the public was important in developing the plan. While some
actions are already underway, complete implementation of this plan will require close collaboration with all of these
partners, (b) a major objective of the process. The plan will be implemented incrementally, dependent on the availability
of resources. The Action Plan provides a blueprint for specific, coordinated federal actions to address the emerging
threat of antimicrobial resistance. This document is Part I of the Action Plan, focusing on domestic issues. Since AR
transcends national borders and requires a global approach to its prevention and control, Part II of the plan, to be
developed subsequently, will identify actions that more specifically address international issues. The Action Plan, Part I
(Domestic Issues), includes four focus areas: Surveillance, Prevention and Control, Research, and Product
Development. A summary of the top priority goals and action items in each focus area follows.”
http://www.cdc.
gov/drugresistance/actionplan/aractionplan.pdf

Restricting antibiotic use was the USDA theme in a 2000 speech at the Conference on Antimicrobial Resistance. While
USDA was the primary research and sales agency for promoting antibiotic resistant contaminated sewage sludge on
agricultural land as a fertilizer, the current trend is to blame the agricultural community for the overuse of antibiotics.
This was the focus of Dr. Catherine Woteki, USDA Under Secretary for Food Safety, when she reported on
“Antimicrobial Resistance—The USDA Perspective.” Woteki said, “The complexity of the antimicrobial resistance issue
stems from the fact that two previously parallel stories are now converging. First is the story of how the inappropriate
use of antibiotics in human medicine has contributed to the growing human health problem of antimicrobial resistance.
The second story is the use of antibiotics in animal agriculture, and the growing recognition that this practice contributes
to antimicrobial resistance in both animal and human pathogens. – The need to take action now to address the problem
of antimicrobial resistance in our animal populations does not mean we have all of the answers to our questions. Many
data gaps remain. For example, we do not know what degree of resistance is transferred for various organisms. In many
cases, we do not even know exactly how resistance is transferred. We also do not know which practices related to
antibiotic use present the greatest risks.  – We have long recognized that the health of food-producing animals is
intrinsically linked to human health. But in the past, agriculturists resisted the idea that the use of antibiotics in animals
could relate to resistant pathogens in humans. It's time to move beyond that, because there are now cases that provide
evidence of such a link. For example, a May 1999 article in the New England Journal of Medicine showed a genetic
association between resistant Campylobacter strains from chicken products produced and consumed in Minnesota and
resistant Campylobacter strains causing infections in Minnesota residents. – It is not possible to quantify the contribution
of antibiotic use in the agricultural setting to the broader problem of drug resistance in humans, nor do I believe that this
exercise would be particularly helpful. I believe it is more helpful to acknowledge that antibiotic use in animals contributes
to the problem and that prudent antibiotic use should be encouraged in all sectors. The agricultural community must
accept part of the responsibility.”
http://www.fsis.usda.gov/oa/speeches/2000/cw_antirest.htm

While the focus here is on antibiotic resistance, it should be noted that prior to the first recognized foodborne outbreak
in 1982, antibiotic resistant E. coli 0157:H7 was not found in cattle even though disease organism contaminated sewage
sludge was being used on grazing land under the EPA, FDA and USDA policy.  But that was only eight years after
researchers discovered how to recombine bacterial components, and seven years after the first documented E. coli
0157 human infection in Oakland, CA.  Today, there are over 3,500 unique strains of antibiotic resistant E. coli 0157:H7.

Based on the 1983 EPA study
“Effects on Cattle from Exposure to Sewage Sludge,” it appears that no agency
considered the possibility that viruses and bacteria would infect cattle and pass though into the food supply. The study
focused on toxic metals uptake by cattle, even though it was documented that virus indicators survived 19 weeks,
Salmonella survived 70 weeks and
Fecal coliform (E. Coli-Klebsiella) survived 73 weeks. Sludge desiccation
(dehydration stress) was the major factor in suppressing bacterial growth.    http://thewatchers.us/EPA/1/1983-cattle.pdf

The agencies don't want to collect or remember data that could be damaging to their image. As an example,  according
to the  U.S. Medicine August 2011 article: “
GAO Lack of Information on Inpatient Antibiotic Use Hampers Resistance
Monitoring
.” The article states, “According to the report, federal agencies do not routinely quantify the amount of
antibiotics produced in the United States for human use. While the Centers for Disease Control and Prevention (CDC)
monitors antibiotic use in the outpatient setting, the agency’s ability to monitor use in the inpatient setting has gaps.
Also, the major surveys looking at medical care services in the U.S. — NAMCS and NHAMCS — do not capture use of
antibiotics in the inpatient setting. – Federal agencies also are failing to collect data on the disposal of antibiotics, even
though both the Environmental Protection Agency and the U.S. Geological Survey have measured the presence of
certain antibiotics in the environment due, in part, to improper disposal. Studies have shown that antibiotics in the
environment can lead to bacterial resistance in humans.”
http://www.usmedicine.com/infectiousdisease/gao-lack-of-information-on-inpatient-antibiotic-use-hampers-resistance-
monitoring.html?page=1

The GAO states in the June 2011 report “ANTIBIOTIC RESISTANCE – Data Gaps Will Remain Despite HHS Taking
Steps to Improve Monitoring
,” “Antibiotics are drugs that are used to treat bacterial infections. Antibiotics work by killing
or slowing the growth of bacteria and they are not effective against nonbacterial infections, such as those caused by
viruses. Antibiotic resistance is the result of bacteria changing in ways that reduce or eliminate the effectiveness of
antibiotics to cure infection. Antibiotic use forces bacteria to either adapt or die in a process known as “selective
pressure.” Selective pressure means that when an antibiotic is used, some bacteria will be killed by the antibiotic while
other bacteria will survive. Bacteria are able to survive, in part, because they have certain genetic material that allows
them to avoid the effects of the antibiotic. The surviving bacteria will multiply and pass on to future generations their
genetic material that is coded for resistance to antibiotics.”
http://www.gao.gov/new.items/d11406.pdf

Many studies are available on antibiotic resistance, if the federal agencies were interested enough to research them.
However, the fact is that the federal agencies make a point to exclude most of them from their data bases. No agency
wants this data readily available because they are involved in creating the perfect storm of antibiotic resistance.


Next
Basic Antibiotic Resistance History