Quick alert: Congressional hearing Wednesday

Constant readers, I'm on the road again: Georgia Center for the Book tonight in Decatur, 7:15 p.m. But if you can't make that, take a look at this: The Energy and Commerce Subcommittee of the US House of Representatives has announced a hearing for Wednesday on "Antibiotic resistance and the threat to public health."

This is not a hearing on PAMTA, but apparently a broader hearing on the whole issue, featuring two VIPs: Dr. Anthony Fauci of NIH and Dr. Tom Frieden of the CDC. To my eye, this indicates that official, policy interest in this issue is (finally, at last) ramping up.

The hearing page is here and the preliminary memo on it is here.

Bad news in the President's budget request

It's been a few days since the rollout of the White House's proposed 2011 budget request, time enough for people to dig deep into the minutiae and figure out what that massive document really says. The Infectious Diseases Society of America has done the drilling for the health and infectious disease line items, and I'm sorry to say the news is not good.

Worst first: The proposed budget would cut funding for the CDC's antimicrobial resistance programs by 50%, $8.6 million. That means that only 20 state or local health departments, or health care institutions, will get money from CDC for surveillance and control of resistant bugs. That's only 40% of what was funded this year, when 48 health departments and health systems were funded. Which is very disturbing: If there's one thing almost everyone agrees on with regard to MRSA, it's that we need more surveillance, not less.

In addition, all state grants in the Get Smart About Antibiotics program, which runs campaigns to reduce inappropriate use, get zeroed out.

There are other cuts as well to infectious-disease program at CDC and elsewhere in HHS, including to to a major childhood immunization program and to pandemic defenses. And funding for HIV/AIDS, TB and other NIH research programs barely tiptoe upward.But these frank cuts in programs to combat antimicrobial resistance, at a time when MRSA is burgeoning, Gram negative organisms such as Acinetobacter are gaining ground, and drug development is stalling, surely cannot be smart.

The IDSA analyis is here.

MRSA in the food chain?

Behind the growing number of findings of MRSA in food animals and the humans who work with them — in the Netherlands, Canada and now in the US — there lurks a persistent concern that the meat of those animals could be a vector for MRSA transmission. Dr. J Scott Weese of the Ontario Veterinary College raised the possibility in a presentation I reported on at the International Conference on Emerging Infectious Diseases, and Dutch researchers raised it in a paper last year as well.

Until now, though, it has been a hypothetical concern, since the humans found with pig-associated MRSA (both the already-recognized community and hospital strains and the emerging ST 398 strain) have all been animal workers.

So much for hypothesis. The London newspaper The Independent is reporting that the ST 398 strain has sickened three patients in Scotland who have no connection to animal raising or slaughtering, suggesting their infections came from contact with raw meat.

All three patients, who were being treated in at least two different Scottish hospitals, recovered. Confirming the cases, Dr Giles Edwards, director of the Scottish MRSA Reference Laboratory, said: "A lot of the patients who got this infection in Holland and Canada have been people who work with animals, such as farmers and vets. But none of the three individuals in Scotland have been in contact with animals, not that we could find." (Byline: Martin Hickman)

The bug has not currently been found in pigs raised in England, but about two-thirds of pork sold in the UK is actually imported from the Netherlands. So the Soil Association (the British farming lobby) has asked the government to begin testing imported pork for MRSA strains. The British Food Standards Agency disagrees, however, telling the Independent it does not "see serious food safety issues."

Which is strikingly close to what CDC Director Dr. Julie Gerberding said in February when asked by the House Committee on Agriculture about the Dutch and Canadian reports:

... although the finding of MRSA in retail meats suggests a possible role for foodborne transmission, if such transmission occurs, it likely accounts for a very small proportion of human infections in the United States. (Letter .pdf archived here on the site of the National Pork Producers Council.)

Hmmm.

UPDATE: The Soil Association's statement, with some good additional references (including to a newspaper report by the Sunday Post two days before the Independent's) is here. More to come on this, I think.

HAIs: Congress weighs in

Today, the House of Representatives Committee on Oversight and Government Reform held a hearing on hospital-acquired infections, led by committee Chairman Henry Waxman (D-Calif.).

The witness list is here. A Government Accountability Office report that was presented during the hearing is here. Its title captures the committee's point of view: "Leadership Needed from HHS to Prioritize Prevention Practices and Improve Data on These Infections."

In opening the hearing, Waxman said:

[HHS] is not providing the necessary leadership. It has not identified for hospitals the most important infection control practices, and it is not coordinating the collection of data from hospitals in order to avoid duplication and unnecessary burden.
The failure of HHS leadership is particularly regrettable because these illnesses, deaths, and costs are preventable. Moreover, the preventive measures don’t require new technologies or large investments.

The witness list includes links to testimony, including some very powerful remarks delivered by HA-MRSA survivor Edward F. Lawton:

We possess the knowledge and capabilities to fight this enemy; we possess the educational and professional expertise to overcome and destroy it. The only question is whether we have the will to fulfill the mission!

(And BTW, apologies to loyal readers for disappearing for a week. I was speaking at the American Society of Journalists and Authors, and doing book-related research in New York. Back now.)