Fluoroquinolone Resistance in Salmonella: A Web Discussion

Dr. Rich Carnevale of the Animal Health Institute (Washington, DC) was asked by Dr. Abigail Salyers, who runs the Reservoirs of Antibiotic Resistance (ROAR) web site, to comment on the article by Mølbak et al. [1] published in the New England Journal of Medicine in November 1999. Dr. Salyers requested that the article in the New England Journal of Medicine [1] be discussed, since it may have demonstrated a bridge to clinical impacts in humans from antibiotic-resistant bacteria in animals. There are other researchers with far more expertise to judge the conclusions drawn by the authors, but it seems to me that the study falls short of clearly documenting that antibiotic use in animals was directly responsible for the deaths noted in the study. What the study showed was that food animals, in this case pigs, can be a source for Salmonella and, in particular, the DT104 strain. However, it also indicated instances of person-to-person transmission and the curious matter of 18 of 27 patients who consumed pork, apparently all of which was in a raw or near-raw state. Pork is generally cooked quite well, since the threat of trichinosis has been well communicated to most consumers. Therefore, without further information on how these people actually handled and processed the pork products, we do not know why the food would have presented such a risk.