Day 106 - 23 Mar 95 - Page 21

     
     1        opposed to other strains.  So, we have, if you like, to
     2        coin a phrase, a double whammy.  We have an organism which
     3        is more likely to be invasive, i.e. requiring antibiotic
     4        treatment, at a time when that organism is proving to be
     5        resistant to a group of antibiotics normally used for their
     6        treatment, for the treatment of the invasive condition.
     7
     8   Q.   But, what are you saying the state of knowledge is now as
     9        to resistance of that invasive -- once a patient has got to
    10        that invasive stage, antibiotics being less useful, to put
    11        it in lay terms?
    12        A.  That is quite the case, yes.
    13
    14   Q.   But are you saying that is established or not?
    15        A.  Oh, very much so, yes, my Lord, very much so.  It has
    16        been the subject of a number of learned papers and is
    17        causing considerable concern within the Public Health
    18        community.
    19
    20   MS. STEEL:   Do you know which the particular antibiotics
         concerned are?
    22        A.  Not offhand, no, other than to say they are the ones
    23        normally used in therapy for that type.
    24
    25   Q.   Ones that will widely used in the meat industry as well?
    26        A.  No.  That is the puzzle.  With some slight overlap,
    27        veterinary antibiotics tend to be different from those used
    28        in human therapy, but there is substantial evidence that
    29        the resistant factors that build up, say, in relation to
    30        one antibiotic can be transferred to other antibiotics.
    31
    32   Q.   Is that because some of the antibiotics used, although not
    33        exactly the same, are pretty similar?
    34        A.  Similar mechanisms, yes.  It is a very arcane area, to
    35        say the very least.
    36
    37   Q.   Just going back to the particular conditions in intensive
    38        farming, talking about broilers, is there a problem in
    39        terms of transmissibility or infection rates with the fact
    40        that the birds are housed on their own environment/index.html">litter or their
         own ----
    42        A.  It starts before that in the breeding flocks and the
    43        hatcheries.  Do not forget, if you are using intensive
    44        birds, your breeding is also intensive.  Because it is
    45        under controlled conditions, the birds are not normally
    46        exposed to the package of bacteria which a wild or a free
    47        range bird would, so they do not aware immunity to a wide
    48        range of potential pathogens.  Therefore, you have
    49        basically an empty slate.
    50 
    51        Birds with very limited immunity coming into an environment 
    52        in very close proximity and, in fact, if one appreciates 
    53        these birds in a shed are eating, sleeping and, of course,
    54        defecating all within the same environment, you introduce
    55        an infectious organism in, and it will tend to spread like
    56        wild fire.  So, that is a function, it is multifactorial
    57        function, the fact that the birds will tend to have limited
    58        immunity unless, of course, you have specifically
    59        vaccinated them.  Also, their proximity maximises ease and
    60        speed of spread.