BBC ‘Real Story’ Investigation - UK - A BBC ‘Real Story’ investigation was broadcast on 15th August, which looked into antibiotic resistance in the food chain. The Health Protection Agency has been advising the BBC on the making of this programme for many months.

One of our laboratories carried out the testing for levels of antibiotic resistant bacteria found in chicken, and we have also provided a number of briefings and interviews with our scientists.

The testing carried out for the BBC was similar to previous studies and did not highlight any new areas of concern. Using these results the programme has continued to assert various links between the use of antibiotics in farming, levels of resistant bacteria found in the chicken samples and human illness. The science is not there to prove some of these assumptions and therefore the HPA does not support them.

Whilst we are concerned about any antibiotic resistance, and particularly any bacteria in our food that are multi-resistant to antibiotics used in clinical care, this is an area of work we have been monitoring closely for many years and on which we work closely with other organisations like the Food Standards Agency (FSA), the Advisory Committee for the Microbiological Safety of Food (ACMSF) and the Department for the Environment Food and Rural Affairs (Defra).

We would like to reassure any viewers of the programme that most people who suffer from bacterial food poisoning, although experiencing an unpleasant illness, will make a full recovery and will not need any antibiotic treatment and the fact that food poisoning bacteria are resistant to antibiotics in itself will not make their infection more serious.

Antibiotics are usually only prescribed for the more serious effects of food poisoning, for example, when the bacteria get into the blood stream, which is not common. In such cases if a patient’s infection does not respond to the first antibiotic treatment prescribed then testing will usually be carried out to establish if the bacteria are resistant and a different antibiotic will be prescribed.

The development of antibiotic resistance is an inevitable consequence of the use of antibiotics in both animals and humans. Stopping using antibiotics is not feasible in a world where people and animals continue to contract infections, and would result in unacceptable suffering. Nevertheless the careful use of antibiotics is key in controlling levels of resistance and the HPA would emphasise that unnecessary antibiotic use should be avoided in both humans and animals.

In the programme it is implied that a patient developed Crohn’s disease as a result of an infection with an antibiotic-resistant strain of Campylobacter. We would emphasise that Crohn’s disease can be caused by a variety of agents, but there is no evidence that Campylobacter is the definitive cause of Crohn’s disease.

The programme asserted a link between vancomycin resistant enterococci (VRE) infections in humans and those seen in animals. VRE infections in humans are mainly associated with hospitalisation and occur in those patients who are already very sick. These infections involve hospital-adapted strains, not ones acquired from food. Any food-borne VRE do not pose a problem for healthy people in the UK.

The programme also asserted a link between resistant strains of E. coli in poultry and urinary tract infections (UTIs) caused by resistant E. coli strains. It is widely known that E. coli live harmlessly in the gut but are also are a common cause of UTIs. In general, strains of E. coli are adapted to either live in humans or animals. Some transfer of E. coli strains between animals and humans does occur, but most animal E. coli strains are adapted to their particular animal host and do not cause infections in humans. It is therefore unlikely that resistance in an E. coli from a UTI simply reflects resistance in bacteria contained in food that a person has eaten. The majority of more multi-resistant UTIs caused by E. coli, for example those with resistance to extended-spectrum ß-lactamases (ESBLs), as highlighted in the recent Chief Medical Officer’s annual report, are associated with a previous stay in hospital, or with recent antibiotic treatment in humans.

It is important to remember that food poisoning can be avoided by following good food hygiene practices. These include washing your hands before and after preparing food and handling raw meat; thoroughly cooking food and reheating leftovers properly; preparing raw and cooked foods separately; storing food correctly and following a good standard of hygiene in your kitchen. The same recommendations apply for food prepared in restaurants and take-away establishments.

Source: Health Protection Agency - 16th August 2005