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Toxic Megacolon Superbug

Clostridium difficile is another “superbug” found in the U.S. meat supply.

October 15, 2010 |
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Supplementary Info

Sources Cited

W. Wittie. Community-acquired methicillin-resistant Staphylococcus aureus: what do we need to know? Clin Microbiol Infect 7:17-25, 2009.

W. Vanderhaeghen, K. Hermans, F. Haesebrouck, & P. Butaye. Methicillin-resistant Staphylococcus aureus (MRSA) in food production animals. Epidemiol Infect, 138(5):606-625, 2010.

T.C. Smith, M.J. Male, A.L. Harper, J.S. Kroeger, G.P. Tinkler, E.D. Moritz, A.W. Capuano, L.A. Herwaldt, & D.J. Diekema. Methicillin-resistant Staphylococcus aureus (MRSA) strain ST398 is present in Midwestern U.S. swine and swine workers. PLoS, 4(1):e4258, 2009.

S. Pu, F. Han, & B. Ge. Isolation and characterization of methicillin-resistant Staphylococcus aureus strains from Louisiana retail meats. Appl Environ Microbiol, 75(1):265-267, 2009.

S.S. Baker, H. Faden, W. Sayej, R. Patel, & R.D. Baker. Increasing incidence of community-associated atypical Clostridium difficile disease in children. Clin Pediatr (Phila), 49(7):644-647, 2010.

K.N. Norman, R.B. Harvey, H.M. Scott, M.E. Hume, K. Andrews, & A.D. Brawley. Varied prevalence of Clostridium difficile in an integrated swine operation. Anaerobe, 15(6):256-260, 2009.

J.G. Songer, H.T. Trinh, G.E. Killgore, A.D. Thompson, L.C. McDonald, & B.M. Limbago. Clostridium difficile in retail meat products, USA, 2007. Emerg Infect Dis, 15(5):819-821, 2009.

J.S. Weese, R.J. Reid-Smith, B.P. Avery, & J. Rousseau. Detection and characterization of Clostridium difficile in retail chicken. Lett Appl Microbiol, 50(4):362-365, 2010.

N. Macleod-Glover & C. Sadowski. Efficacy of cleaning products for C. difficile: environmental strategies to reduce the spread of Clostridium difficile-associated diarrhea in geriatric rehabilitation. Can Fam Physician, 56(5):417-423, 2010.

U. Jabbar, J. Leischner, D. Kasper, R. Gerber, S.P. Sambol, J.P. Parada, S. Johnson, & D.N. Gerding. Effectiveness of alcohol-based hand rubs for removal of Clostridium difficile spores from hands. Infect Control Hosp Epidemiol, 31(6): 565-570, 2010.

Acknowledgements

Transcript

There’s a new superbug in town. Clostridium difficile, known in short as C. diff. You may remember superbugs from such hits as MRSA last year, methicillin-resistant Staph aureus, now killing more people than AIDS in the United States, MRSA used to just be something you picked up in hospitals, but then, all the sudden, there were all these cases found out in the community and no one knew where it was coming from. Then we discovered MRSA in pigs, veal calves, chickens, and dairy cows. Ah ha! So they tested farm workers, and about half of them were carrying it. So then they tested the meat, and found MRSA right off the supermarket shelves.
In the hospital we have something called contact precautions. Before you can even walk into a room with a patient with MRSA you have to glove mask and gown—even if you’re not even going to touch the patient. There is such a concern that you might just touch some contaminated surface they won’t even let you in the room unless you look like this. Yet we still let kids run up and down the meat aisle at the supermarket, where MRSA contamination has been confirmed
Now, only about 5% of retail meat tested so far in the U.S. has MRSA on it, but if you went to any infectious disease specialist and offered them an object, informing them there was a 5% chance it was contaminated with mersa, MRSA, first of all they wouldn’t touch. And if they had to, they’d definitely glove up. If you handle raw meat, wear gloves—I’m serious, and wash your hands.
What about C diff. C diff used to just be something you picked up in hospitals, but then all the sudden there were all these cases found out in the community and no one knew where it were coming from. Then we discovered C diff in calves, cows, chickens, and pigs. Starting to sound familiar? Then they tested meat, and found C diff right off the supermarket shelves. 42% of meat products sampled contained toxin-producing C diff. The riskiest meat was ground turkey, actually. Relatively common in retail chicken too, and out of legs, wings or thighs, the riskiest body part to touch were chickens’ wings.
MRSA causes nasty skin infections. What does C diff. do? Normally nothing. Even if you get infected and your gut gets colonized with C diff, your good bacteria can usually muscle it into submission. But the C diff just waits patiently until you have to take an antibiotic, for example, and with your good bacteria out of the way, C diff can go crazy, and cause a severe infection of your colon, called pseudomembraneous colitis. Which can get worse, and even turn into a life-threatening condition called toxic megacolon.
This man is not pregnant. This man has toxic megacolon. On autopsy, his colon looked like this.
Yeah, but people don’t eat raw poultry. Doesn’t cooking wipe out most bugs? C diff isn’t like most bugs. For most meat, 71 degrees Celsius is the recommended internal cooking temperature. That’s what our meat thermometers are supposed to reach, just to be safe, err on the side of caution. C diff can survive 2 hours at that temperature. Chicken can be grilled for 2 hours straight and still not kill off C diff.
You know those how those alcohol based hand sanitizers say they kill 99.99% of germs. That 0.01% is C diff. They don’t call it a superbug for nothing. And then residual spores are readily transferred by a handshake even after the use of an alcohol-based hand rub. So you don’t want to touch raw meat, and you don’t want to touch people, who’ve touched raw meat.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring watch the above video. This is just an approximation of the audio contributed by veganmontreal.

To help out on the site please email volunteer@nutritionfacts.org

Dr. Michael Greger

Doctor's Note

Please feel free to post any ask-the-doctor type questions here in the comments section and I’d be happy to try to answer them. And check out the other videos on meat. Also, there are 1,686 other subjects covered in the rest of my videos--please feel free to explore them as well!

For some context, please check out my associated blog posts: Talking Turkey: 9 out of 10 retail turkey samples contaminated with fecal bacteria and Bowel Movements: The Scoop on Poop.

If you haven't yet, you can subscribe to my videos for free by clicking here.

  • JJ

    After watching this video on Volume 4, I was hooked. I haven’t eaten meat in 16 years, but I thought this was so compelling that I wanted to share it with my meat-eating friends. There is rarely one study or one piece of info that can change a major behavior, but this video/information is so impressive, I thought it might change behavior of someone.

    The first person I explained this information to was a friend who happens to be a nurse. My friend said that she had a cousin with MRSA who was in the hospital for quite a while. My friend’s family did not have to glove, mask or gown up when they visited the cousin in the hospital. MRSA is not an air-born, so the mask was not needed. And they were just told not to touch anything.

    Since the part about gloving up was not true in my friend’s experience, it was hard for her to buy into anything else I was saying. Is this video exaggerating any? Are there different protocals at different hospitals? Would it be better to say that at “*some* hospitals you have to glove and mask up?”

    Here’s another part of the response that I got from my friend: She said that lots of people have MRSA on their skins, etc and it is only a problem if the infection gets into the blood. Since so many people have MRSA on their skins already, it is hard to get excited about finding it on meat.

    My friend sent me a MRSA fact sheet that said: “MRSA…are bacteria that often live in the nose or on the skin of healthy people. MRSA can be carried on the skin or in the nose without causing any disease, which is called colonization. Approximately 25-30% of the population is colonized in the nose with staph bacteria at any given time; however, the proportion colonized with MRSA is not known.”

    If MRSA is already on 25% of the population, then surely having kids run down the meat isle at the grocery store is not something to panic about? (The image was very powerful to me before talking to my friend.)

    I still find this video personally compelling, but it is hard to convince other people in light of the above. Do you have a response? What am I missing?

    Thanks!

    • http://nutritionfacts.org/members/mgreger/ Michael Greger M.D.

      I’m afraid you are confusing staph with MRSA. MRSA is a multidrug resistant form of staph (full name: Methicillin-Resistant Staph aureus). So yes, lots of us are colonized by regular staph, but thankfully very few with the much more dangerous MRSA, which is resistant to multiple classes of antibiotics and so is much harder to treat. As I noted in the video, according to the Centers for Disease Control and Prevention, MRSA kills more people than AIDS in this country, more than 18,000 Americans dead every year. I’ve personally never worked in a hospital that didn’t require what are called “contact precautions” for MRSA (glove, mask, and gown) but am horrified to learn that indeed the CDC allows some leeway in how individual hospitals deal with the problem. See the official CDC recommendations here. I’m glad I don’t work where your friend works!

      There used to be a time when simple scrapes could turn into mortal wounds before the miracle of antibiotics arrived on the scene. Now with the rise in multidrug resistant bacteria many experts fear we may approaching a post-antibiotic age. That is why we need to stop the squandering of this precious resource by feeding it to the millions of pounds to animals on factory farms just to promote growth or prevent disease in such overcrowded, unhygienic, stressful conditions. I suggest checking out Keeping Antibiotics Working for more information in general, and “What the USDA Doesn’t Want You to Know…,” an excellent exposé published last month in Mother Jones.

      • JJ

        Thank you again Dr. Greger for your very helpful reply! This definitely helps to put things into perspective for me. I am sharing your reply with my friend, but it also helps me to understand the big picture and clarifies what you were saying in the video.

        I’ve long heard about the problems with over-use of anitbiotics. I’ve been careful not to buy soaps, etc with antibiotics in them. I’m sure that is probably the tip of the iceberg when it comes to the abuse by the factory “farmers”. Between my soap buying and my refusal to eat most (I’m still eating honey) animal products, I figure I’m at least making a difference on a personal level.

        I really appreciate all the links you provide that back up what you say. Also very helpful! Thanks!!

        • bt

          “Between my soap buying and my refusal to eat most (I’m still eating honey) animal products, I figure I’m at least making a difference on a personal level.”

          to be totally honest, i dont think an individual being vegetarian or vegan can make a difference for something like this…

          the fact that some people are vegetarian or vegans doesnt stop the factory farms from using antibiotics…and as long as the factory farms use antibiotics on animals, drug resistant bugs will emerge…and once these bugs are in the community- it effects everyone INCLUDING the vegans or vegetarians.

      • JJ

        I also wanted to say, you are right: I WAS confusing staff with MRSA. I went back and re-read the paragraph that I quoted more closely and even that paragraph says that what you are saying. I was more thinking about what my friend *said* than what the literature she sent me actually said. Thanks for pointing that out.

  • http://nutritionfacts.org/members/JenniferEldred/ Jennifer Eldred

    Not a good video if you have OCD, but one of the reasons why I went veg 12 years ago is because of all the gross stuff in animal protein. So glad I did!

  • http://nutritionfacts.org/members/KarenHyde/ Karen Hyde

    I live in the UK. I have to have a very minor surgical procedure soon and at my initial hospital appointment was swabbed for MRSA so know I am clear of it.
    I recollect c.diff. getting into a section of the water supply a few years ago and a medical scientist friend telling me that if you boil the water it just forms a protective cyst around itself rather than being destroyed.
    The more disinfectant and antibiotics we develop, the more resistance new generations of bugs are going to become to outwit us.
    I am a tad OCD about hand washing in the kitchen, prepare raw meat in an empty sink which is then scrubbed and cook it to 90 degrees.
    Haven’t poisoned anybody yet, but that mega-colon really does make you think. Ew!!

    • http://nutritionfacts.org/members/mgreger/ Michael Greger M.D.

      The official recommendation (at least here in the States) is that one should never wash meat in the sink (or anywhere else) given the potential for cross contaminating kitchen surfaces with bacteria. So even though you try to be careful about cooking it (for my metric-challenged friends out there Karen is talking about around 200 degrees Fahrenheit), the concern is that some “juice” will splash onto a kitchen sponge, towel or utensil that isn’t properly cooked and be a source of infection). That’s why researchers here in Arizona found more fecal bacteria in peoples’ sinks than on their toilets, because people were washing raw chicken. All I’m saying is please be careful! See other foodborne illness videos here.

      • Therese Dion Cuba

        Where are you suppose to wash chicken?

        • Joe

          If you look at the food poisoning data, the vast majority come from animal product exposure. But I think it’s also fair to point the finger at intensive farming – including fruits and vegetables – as that can also lead to contamination. Home grown is safest!

  • http://nutritionfacts.org/members/toxins/ Toxins

    How would can I test for C diff or MRSA? I have been vegan for 9 months but like you say, it could be incubating inside me.

    • http://nutritionfacts.org/members/sarmstrong/ SArmstrong

      People who are colonized with MRSA usually have it in their nose. A swab can be done to check for this, however if you’re not sick it probably doesn’t help you to know this. C. difficile can be detected in stool cultures, especially when there’s a lot of it (in a person who is sick with C. diff infection), but again, what to do with the information that you’re colonized? It’s interesting that in Europe, where the hospital MRSA problem is much less than in the United States, all elective (non-emergency) hospital admissions require being tested for MRSA with a nasal swab before admission (as Karen, above, notes). For some reason we in the US consider this some kind of privacy violation, and so instead we let our hospitals be petri dishes full of MRSA.

  • http://nutritionfacts.org/members/shintaido-leslie/ Shintaido Leslie

    Great. Now I’m afraid to go to my brother’s for the family Thanksgiving. I thought having to look at the bird and endure tasteless jokes about killing livestock animals was the worst of it.

  • http://nutritionfacts.org/members/bradtka/ bradtka

    What a bunch of propaganda. Check your science people, don’t be led blindly by people with an agenda. This people are not living in reality.

    • http://nutritionfacts.org/members/toxins/ Toxins

      Bradka, I am confused as to why you say this. If you view the “Sources Cited” tab you can view all of the scientific papers and studies from scientific journals, such as the national library of medicine, that were used for this video. It isn’t a matter of opinion, its factual information that is being said here. If you disagree, that my friend is an opinion.

  • bockius

    Dr. Greger- Wow, the video is frightening and particularly frightening for me. I am 57 now, but I remember back in 1990 when I was first diagnosed with IBS. Later in 1999 I was having dreadful diahrea (sic) again and after multiple tests the doctor, so triumphantly called me so say they found an odd, unusual bug: C diff. The first he had ever heard of it. So odd, back then! For the last 5 years I have had returning symptoms and now I have a chronic CDAD that is well beyond anything mild. I have been treated repeatedly by doctors who have no clue how bad this is and I am suffering painfully and do not want to eat, nor do I enjoy food anymore. Are there any suggestions you can give me. You, as a doctor, knows I cannot try to tell these doctors their business, they do not listen. Please help me save my own life. 

    • bockius

      I would really appreciate a private reply, Dr. Greger. My email is bockius@succeed.net. Thank you.

    • http://www.DonForresterMD.com/ Don Forrester MD

       Chronic diarrhea can have many causes. In my experience we in the Medical profession often use IBS as a diagnostic term to cover diarrhea and/or constipation with or without abdominal pain for which we have ruled out other causes like cancer, ulcerative colitis and Crohn’s Disease. This is complicated by the complexity of the intestine itself along with its many bacteria see http://nutritionfacts.org/video/flax-and-fecal-flora/. The trouble with recurrent use of antibiotics is that it can adversely effect the bacteria in the gut. More recently the issue of gluten is getting alot of press… http://nutritionfacts.org/video/is-gluten-bad-for-you/. It is confusing. Working with your physicians is important since it is possible that there is more then one thing going on. To help you and your physicians sort this out you might find useful suggestions and information in two of Dr. John McDougall’s newsletters which are available on his website. “Chained to the Bathroom” published in November 2002 and “Could it Be Celiac Disease” published in September 2005. These link to others which might be of interest on probiotics and his elimination diet. Dr. McDougall has had alot of practical experience and success over the years. Hopefully you will be able to achieve the benefit achieved by one of my “Meals for Health” patients who had chronic diarrhea labeled as IBS. If you go to http://www.EarthSave.org website you can view the 7 minute video of 5 testimonials (see top video). The last testimonial by Kimberlee is the one I am referring to. Kimberlee and I will never know what it was in her diet that was causing her difficulties. Good luck.

  • Michael Greger M.D.

    For some context, please check out my associated blog post Talking Turkey: 9 out of 10 retail turkey samples contaminated with fecal bacteria!

  • Therese Dion Cuba

    Holy crap!