MCR-1 on NPR - Another sign of the antibiotic apocalypse

Just a quick heads up that there will be a discussion on the newly discovered plasmid-mediated colistin resistance mechanism (MCR-1) during the second hour of "On Point" with Tom Ashbrook today on your local NPR station, podcast and online. This strain was recently detected in animal, raw meat and patient samples in China and was just reported in Lancet ID. After this discovery, investigators in Denmark scanned their collection of approximately 3000 salmonella and E coli samples and found one patient who was infected (bacteremia) with an MCR-1 with five additional food samples positive for MCR-1. An overview by Mary McKenna of the original report can be found over at National Geographic (here) and she continued the great coverage of the emergence of MCR-1 with further strains detected in Denmark and the UK. (new post here)

The radio program/podcast will feature Maryn McKenna, Lance Price from George Washington University and Robert Skov from Statens Serum Institut in Copenhagen. Three fantastic discussants. Hope you have time to listen.

How does a study become an internet meme?

According to the internet the steps to starting an internet meme are: (1) have an idea, (2) find a picture that reflects what you want to imply and (3) "now this is where the skill comes in."  The first two steps are pretty easy to understand, but I'm currently trying to sort out what step 3 actually means.

For an example of a study becoming a meme witness Maggie Carrel's (geography professor at Iowa) recent ICHE study where she geocoded Iowa Veterans and found that those living near a large pig CAFO where at greater risk for MRSA nasal colonization on admission to an acute care hospital. You can read a bit more about her study in Maryn McKenna's Wired blog post.  I suspect Maryn's writing is where the skill comes in because Maggie's study is now a meme (image below) from PEW's health initiative - Supermoms Against Superbugs. Super.

h/t to co-author Tara Smith for finding the meme.

Antibiotic-free pork ≠ #MRSA-free pork

Ashley O'Brien in Tara Smith's UI lab has a new study out in PLoS ONE looking at MSSA and MRSA in fresh retail pork samples.  Tara has a comprehensive blog post covering this study and their prior work leading up to this paper, so check it out if you want a lot of the details.

Briefly, they collected 395 samples from 36 stores in IA, MN and NJ. 300 samples were from "conventional" pork and 95 were from pork labeled "raised without antibiotics."  S. aureus was found in 67% of conventional samples and 57% of antibiotic-free samples, while 6.3% of conventional pork and 7.4% of antibiotic-free pork were contaminated with MRSA.

This is a relatively small study, so it likely should be repeated.  Also, as Tara mentioned in her post, in the states included in this study, very few USDA-certified organic products were available unfrozen, and they targeted sampling of fresh meats.  It is hard to speculate why MSSA and MRSA didn't differ significantly between the types of pork, but contamination during processing or at retail is certainly possible.  Could it be that conventional and antibiotic-free pigs are raised in close proximity?

O'Brien AM et al. PLoS ONE January 2012

Novel H3N2 Influenza in Iowa: More bad news from pig country

PIGS: Portugal, Italy, Greece and Spain

When it rains, it pours.  Dr. Patricia Quinlisk, medical director for the Iowa Department of Public Health, announced today that a novel H3N2 influenza A strain had infected three Iowa children.  Evidence points to one child transmitting the virus to the other two. There have been seven prior cases of this strain, all in the US (Maine, Indiana and Pennsylvania) and all apparently linked to animal exposure, which makes the Iowa cases unique. All but one case has been in children under 10 years old, suggesting prior year exposure to H3N2 might be protective. Perhaps it's ironic that this novel swine strain was first transmitted from human-to-human right here in pig country.

Sources: Des Moines Register 11/22/2011 and Winnipeg Free Press 11/22/2011

Addendum: Iowa just added 2,300 jobs, which I think is about double our human population.  I think two job seekers family members (update:  actually just in for Thanksgiving) from other states even moved in with Dan this past weekend.  Getting crowded here, which might be increasing the flu transmission.

Actual update on the virus: "In these ten most recently reported cases, the virus has been a swine H3N2 virus with the M segment gene borrowed from the 2009 H1N1 virus. Essentially a hybrid – a new reassortant virus - that until this summer had not been seen before." source: Avian Flu Diary

More bad news from pig country

It is kinda funny moving back to the Midwest after spending almost 20 years on the east coast. To be specific, I grew up in the East North Central region (Great Lakes States) and now find myself in the West North Central (Great Plains States); never mind that Iowa isn't actually in the Great Plains.  People are always asking why I would move back or what's it like there in flyover country or the heartland or Middle America - I just smile and say that "all the women are strong, all the men are good looking and all the children are above average." Most of the over-stressed, over-crowded coastal folk have at least heard of Garrison Keillor, so that usually changes the conversation...

The Atlanta Braves' new mascot?

OK, so Maryn McKenna has a nice post over on her Wired Superbug blog discussing two studies looking at MRSA in US retail meats. She first reviews a study by Blake Hanson in Tara Smith's U. Iowa lab that found MRSA in retail pork including spa type t034 (ST398). 

The second paper from University of Maryland College Park included testing of 694 samples of retail ground beef, ground pork and ground turkey in the DC area. The somewhat surprising finding was the 17% of turkey and 17% of pork samples were contaminated with MRSA.

The funny part of McKenna's post was that she said that Tara Smith's work was particularly important because "they probably know ST398 better than any other US team looking at the strain" (OK, that's good) "and unlike the other research groups, they are embedded in pig country." ???

We can all agree that Iowa produces a lot of pork, but what about Virginia which is #4 or #5 in turkey production.  I guess, we can refer to people in Alexandria as being from turkey country. Oh, and Georgia is #1 in broiler production, so people from Atlanta are now from chicken country.  I guess, this re-transplanted Midwesterner is becoming overly sensitive...

Addendum: Strictly speaking, PIGS countries are Portugal, Italy, Greece and Spain which are in the midst of an economic crisis. Iowa's unemployment rate sits at 6% and is operating in a close to balanced budget.