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I nearly lost a hand and could have lost my life, as 11,000 fellow Americans do each year, when that chance 2007 encounter with MRSA (methicillin-resistant staphylococcus aureus) landed me on hospital operating room tables, three times. Last week’s Centers for Disease Control report, Antibiotic Resistance Threats in the United States 2013, warns MRSA deaths represent only half the total lives lost annually to 18 bacterial pathogens that have become exceedingly difficult to treat with available drugs. CDC cites abuses in human and animal medicine for this long-developing crisis. Popularly viewed as miracle cures, antibiotics have been inappropriately demanded by patients and dispensed by frustrated physicians for the most trivial of complaints. Last week, Duke Medicine researchers announced development of a 12 hr. blood test “to accurately identify viral infections, a tool that could curb the indiscriminate use of antibiotics and reduce the development of resistant pathogens.” When agriculturists discovered that continuous low-level antibiotic doses discourage animal disease under crowded conditions and promote rapid weight gain, CAFOs (confined animal feeding operations) became our pharmaceutical industry’s biggest customer. In today’s United States, nearly 80% of all antibiotics are purchased without prescription and administered to animals for these purposes without requirement to even disclose their use. CDC’s report clearly acknowledges “much of antibiotic use in animals is unnecessary and inappropriate and makes everyone less safe”, but our Food and Drug Administration consistently refuses to regulate animal industry practice despite decades of urging by infectious disease experts. Following 2010’s passage of the Food Safety Modernization Act (FSMA), that same FDA was awarded historically unprecedented oversight of the nation’s produce farms. For farms like ours they display no reluctance to regulate. Major killer MRSA was once a uniquely hospital-evolved and acquired pathogen. Its “community acquired” (CA) cousin is on the ascendancy, while the hospital version (HA) recedes. Though thwarted by farms’ reluctance to participate, University of Iowa epidemiologist Tara C. Smith et al. managed to sample 43 Midwest swine herds for MRSA, finding 0% in the half not treated with antibiotics and an 8.5% infection rate in medicated animals. Another recent JAMA Internal Medicine-published study revealed that people from a large sample Pennsylvania population who lived close to hog farms or farmlands on which raw pig manure was spread were 38% more likely to acquire CA-MRSA infections. Confronting livestock to human transmission of antibiotic-resistant infectious agents requires courage sadly absent in this Food Safety Modernization Act. –Tom Willey