[Congressional Record Volume 159, Number 94 (Thursday, June 27, 2013)]
[Senate]
[Pages S5503-S5504]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mrs. FEINSTEIN (for herself, Ms. Collins, Mr. Reed, Ms. 
        Cantwell, and Mrs. Boxer):
  S. 1256. A bill to amend the Federal Food, Drug, and Cosmetic Act to 
preserve the effectiveness of medically important antimicrobials used 
in the treatment of human and animal diseases; to the Committee on 
Health, Education, Labor, and Pensions.
  Mrs. FEINSTEIN. Mr. President, I rise today to introduce the 
Preventing Antibiotic Resistance Act.
  This legislation puts in place reasonable safeguards on when and how 
antibiotics can be used in agriculture.
  Few people realize that antibiotics are used in animal agriculture; 
even fewer realize the scope of the problem.
  Last year 29.9 million pounds of antibiotics were sold in the U.S. 
for meat and poultry production. That is four times what was used in 
all forms of human medicine.
  But there is more to be concerned about. The vast majority of these 
drugs are fed to healthy livestock and poultry, with little or no 
veterinary oversight. The drugs are used for growth promotion, to 
fatten up animals before slaughter.
  At these low levels, the doses are not large enough, or powerful 
enough, to eliminate all the bacteria inside the animal's body. The 
small dose only kills off the weakest bacteria, leaving the strongest, 
most resistant bacteria behind to reproduce.
  It creates a perfect storm for antibiotic resistance.
  This isn't just a problem for the animals. These antibiotic resistant 
pathogens make their way into our food, our water, and our communities.
  A recent study published in the medical journal Clinical Infectious 
Diseases found that nearly 50 percent of grocery store meat was 
contaminated with antibiotic resistant pathogens. Even more concerning, 
25 percent of the meat was contaminated with pathogens that were 
resistant to three or more type of antibiotics.
  Antibiotics are the closest thing to a ``silver bullet'' in human 
medicine. They are capable of wiping out a wide variety of bacterial 
infections. But we are in danger of losing this weapon in the fight 
against infectious diseases.
  Tens of thousands of people in the U.S. die each year from antibiotic 
resistant infections. Unfortunately, we are learning the hard way that 
these precious, lifesaving drugs no longer work as well as they once 
did.
  That is why I am so committed to this bill, to preserve the efficacy 
of these drugs that save lives every day.
  The Preventing Antibiotic Resistance Act directs the Food and Drug 
Administration to prohibit the use of antibiotics in ways that 
accelerate antibiotic resistance.
  The bill requires drug companies and producers to demonstrate that 
they are using antibiotics to treat clinically diagnosable diseases, 
not just to fatten their livestock.
  But the bill takes a nuanced approach; the restrictions only apply to 
the limited number of antibiotics that are critical to human health. 
Any drug not used in human medicine is left untouched by this 
legislation.
  The Preventing Antibiotic Resistance Act also preserves the ability 
of farmers to use all available antibiotics to treat sick animals. If a 
veterinarian identifies a sick animal, or a herd of animals that are 
likely to become sick, there are no restrictions on what drugs can be 
used.
  This legislation is not revolutionary. Fifteen years ago Denmark 
became the first country to ban the routine use of antibiotics in the 
food and water of livestock. The entire European Union

[[Page S5504]]

followed suit in 2006. Australia, New Zealand, Chile, Korea, Thailand, 
the Philippines and Japan have also implemented full or partial bans on 
non-therapeutic uses of antibiotics.
  But the majority of producers in the U.S. have not followed suit; and 
it is time for a wakeup call.
  Put simply--irresponsible use of antibiotics endangers us all. And if 
the drugs can't be used safely, they shouldn't be used at all.
  Some still refuse to accept the facts; they say that there is no 
evidence that antibiotic use in agriculture leads to infections in 
humans.
  They are wrong.
  Rear Admiral Ali S. Khan, MD, MPH, Assistant Surgeon General and 
Director of the Office of Public Health Preparedness and Response at 
the Centers for Disease Control and Prevention, testified in the House 
Energy Committee that ``studies related to Salmonella as both a human 
and animal pathogen, including many studies in the United States, have 
demonstrated that use of antibiotic agents in food animals results in 
antibiotic resistant bacteria in food animals, resistant bacteria are 
present in the food supply and are transmitted to humans, and resistant 
bacterial infections result in adverse human health consequences, e.g., 
increased hospitalization.''
  Doctor Joshua Sharfstein, Principal Deputy Commissioner of the Food 
and Drug Administration, also testified at the hearing and agreed with 
Rear Admiral Khan. The FDA, he said, ``supports the conclusion that 
using medically important antimicrobial drugs for production purposes 
is not in the interest of protecting and promoting the public health.''
  Quantitative evidence from the EU and Canada also support this 
conclusion. In response to public health concerns about the rise of 
resistance to the antibiotic cephalosporin in Salmonella and E. coli, 
chicken hatcheries in Quebec voluntarily stopped using the drug in 
February 2005. Following the ban, the public health agency of Canada 
reported a dramatic 89 percent decrease in the incidence of resistant 
salmonella in chicken meat and 77 percent decrease in related human 
infections. Once the drug was partially reintroduced in 2007, 
antibiotic resistant infections in people jumped back up 50 percent.
  Unfortunately we are fighting an uphill battle with antibiotic 
resistant infections. Our tools and resources are diminishing even 
while the number and severity of these infections are increasing.
  One example is Methicillin-resistant Staphylococcus aureus, or MRSA. 
According to the Centers for Disease Control and Prevention, CDC, MRSA 
infections in 1974 accounted for only two percent of the total number 
of staph infections; in 1995 it was 22 percent; and by 2004 it was 63 
percent.
  CDC estimates that by 2005, there were 94,360 MRSA infections in the 
United States. Tragically, about 19,000 of them, 20 percent, were 
fatal. The primary reason is that MRSA is virtually immune to almost 
every antibiotic used in modern medicine.
  By comparison, during the same year there were 17,011 deaths due to 
AIDS; so the scope and consequence of this problem is stunning.
  Of course not all MRSA is derived from the overuse of antibiotics on 
the farm. Many infections are acquired in the hospital, and it is 
believed that these bacteria became resistant to antibiotics due to the 
misuse of drugs in human medicine.
  But MRSA is infecting individuals who have not been in a hospital 
setting.
  There is strong evidence that at least one strain of MRSA infecting 
people is coming directly from livestock. This strain, known as ST398, 
has been shown to disproportionately infect farmers and their families. 
Like all MRSA, ST398 is resistant to the antibiotics methicillin and 
oxacillin. But resistance to other antibiotics is also common among 
ST398 strains which make treatment especially challenging.
  A study by the CDC in December 2009 showed that hospital-acquired 
MRSA strains and community-acquired MRSA strains such as ST398 are 
trending in opposite directions.
  The study found that community-acquired MRSA, a type of MRSA that did 
not emerge in the hospital setting and is not contracted there, 
increased 700 percent between 1999 and 2006.
  By contrast, hospital-acquired MRSA cases declined roughly 10 percent 
over this same time period.
  Over the past decade, it has become clear that MRSA is not just a 
problem for hospital administrators. More and more individuals are 
acquiring this devastating infection in their homes, at their gyms or 
in restaurants.
  While it is exceedingly difficult to determine the exact extent that 
antibiotic use in agriculture influences individual MRSA cases, we know 
for certain that statistical evidence overwhelmingly suggests that a 
reduction of antibiotic use in agriculture will result in a reduction 
of highly resistant MRSA cases.
  Since the recent data released by the FDA confirm that more than 80 
percent of all antibiotics sold in this country are for meat and 
poultry producing animals, one can reasonably conclude that a reduction 
of antibiotic use in agriculture will result in a reduction of highly 
resistant MRSA cases.
  This legislation will very likely reduce the number of resistant 
infections and will very likely save lives.
  But some still claim that this legislation may make our food supply 
less safe. They argue that antibiotics keep our animals healthy, and 
healthy animals make for healthy food.
  But research shows us that these concerns are misguided. More than 
375 public, consumer and environmental health groups, including the 
American Medical Association, the American Public Health Association, 
and the Infectious Diseases Society of America, support the 
legislation.
  This bill makes incremental changes to ensure that our actions on the 
farm do not negatively impact the health and well being of our farmers, 
their families, and every one of us who consume the food they produce.
  I look forward to working with my colleagues to pass these critical 
reforms.
                                 ______