Dr. Visanu Thamlikitkul expresses serious concern about the rapid spread of antibiotic resistant bacteria at the recent SEAOHUN 1st International Conference on One Health.

Researcher warns of rapid spread of antibiotic resistance

A key speaker during a Southeast Asia health conference warns attendees about the rising threat of antibiotic resistance in Thailand.

A highly respected medical researcher has warned that excessive use of the last-line antibiotic Colistin in the livestock industry and in treatment of humans poses a grave and growing health threat to populations in Southeast Asia.

The warning was given by Dr. Visanu Thamlikitkul, head of the Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital at Mahidol University.

Southeast Asia was prone to a growing human and animal health threat due to antimicrobial resistance (AMR) since so many people in the region were carrying antimicrobial Escherichia coli (E. coli), he said in an address during the recent South East Asia One Health University Network (SEAOHUN) 1st International Conference on One Health held at the Prince Mahidol Awards 2017 conference in Bangkok, Thailand.

E. coli can be transmitted from animals to humans during the consumption of raw or undercooked meat or contaminated dairy products.

Up to 70% of the Southeast Asian population were found to be carriers of AMR E. coli. A major indicator of AMR bacteria in humans, food, and animals, it was showing increasing resistance to widely-used antimicrobials, Dr. Visanu said.

The level of E. coli carriers in Southeast Asian populations was the highest in the world and had drastically increased over the past 10 years.

E. coli is common in Southeast Asia and can be transmitted to humans through the consumption of food, such as raw or undercooked meat and dairy products contaminated during production or distribution. Several strains of E. coli have shown signs of drug resistance, contributing to the prevalence of AMR within the region.
 “Food contamination from farm to table has become a growing concern of antimicrobial resistance in food-borne germs, mainly due to excessive use of antibiotics in human, food and animals,” Dr. Visanu said.

Colistin is supposed to be used as “an antibiotic of last resort.” In Thailand, feeding Colistin to animals at pig farms could lead to drug resistant bacteria. Availability of the drug over the counter and smuggling across borders increased the risk of people being infected with seriously drug-resistant bacteria, he said.

He urged the Food and Drug Administration to ban the oral intake of the drug for humans and only allow it to be given to animals if prescribed by a veterinarian.

Dr. Visanu’s urgent warning flies in the face of assurances given recently by veterinary and food safety academics, and the Health Ministry and Department of Livestock Development.

Colistin was essential to livestock production as it helped improve farm conditions and reduce bacterial infections in farm animals, according to Dr. Roongroje Thanawongnuwech, dean of the Faculty of Veterinary Science at Chulalongkorn University.

Assoc. Prof. Rungtip Chuanchuen, head of the Research Unit in Microbial Food Safety and Antimicrobial Resistance at the same university gave a similar assurance, saying there were no reports of antibiotic resistant genes in pigs.

The Department of Livestock Development recently issued an assurance that the use of antibiotics, including Colistin, was closely supervised. The drug was used to kill E. coli bacteria in one-month-old piglets, not for adult pigs. It was safe to eat pork as it was not contaminated with drug resistant bacteria that could be transferred to consumers.

The Public Health Ministry recently announced it intended to cut the rate of antimicrobial-resistant infections in half by 2021.

The government would screen and monitor for AMR, control the distribution of antibiotics, prevent and control AMR in hospitals and medical units, and also in farming and livestock activities. Awareness and cooperation would be improved between relevant agencies, Dr. Sophon Mekthon, permanent secretary for health, said.

They intend to reduce the use of antibiotics for humans by 20% and animals by 30% within this period.

AMR refers to micro-organisms — bacteria, fungi, viruses and parasites — that evolve resistance to antimicrobial substances, such as bacteria, which end up being resistant to antibiotics.

The so-called superbugs, caused by misuse and abuse of antibiotics, are increasingly seen as a threat to public health and the economy.

According to the Public Health Ministry, 88,000 patients developed AMR infections in Thailand last year, and about 38,000 died.

The topic of AMR was interwoven throughout the health conference as SEAOHUN highlighted the importance of the topic in One Health work due to the interaction of humans, animals, and the environment.

Watch speaker videos and find out more about the 1st International Conference on One Health at SEAOHUN’s Facebook page.

About the Author

Apiradee Treerutkuarkul is a communications specialist with the South East Asia One Health University Network (SEAOHUN), a network supported by the USAID One Health Workforce project.

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