Here are reports from three talks at the Symposium on Agriculture and the
Environment .  The first is about E. Coli, by Nancy Hall of the University
Hygenics Lab, a talk on antibiotic resistance and the role of waterways by
Patricia Wilkur of the Department of Internal Medicine in Iowa City and a
presentation about the problems with nitrate in water sources by Peter Weyer.

Peggy Murdock


Microbial tools for tracking the source of E. coli contamination
By Nancy Hall, University Hygenic Lab

Escherichia coli is found in both human and animal intestines.  It is the
predominant fecal coliform bacterium, and an indicator of fecal
pollution.  Its presence indicates that disease producing organisms may be
present, but does not determine whether the source is animal or human.

Watershed management can reduce fecal loading.  This is a prerequisite for
remediation plan formulations. In the past there have been beach closures
in 5 of 35 Iowa state parks.

She described the methods that have been used for detection, and the early
attempts to differentiate the source. One was a fecal coliform to fecal
streptococci ratio. This is inaccurate because one of the organisms
persists longer in the environment.  There is a need for source (animal
species) tracking methods.

She then talked about the methods of source tracking.

Bactgeriophage typing a virus that infects bacteria.  This typing scheme
has four groups: serotypes 1 and 4 indicate animal feces, serotypes 2 & 3,
human and pig feces.

Genotyping is the nucleic acid probe technique.  Group 1 includes both
human and animal, Group 2 humans in North America, Group 3 includes humans
in other parts of the world and Group 4 is primarily animal.  The
University of Massachusetts has received a grant to use this method to test
waterways in Massachusetts and it will be interesting to see the results.

The Toxin Gene Biomarker was developed by Betty Olson of the University of
California in Irvin. It detects the occurrence of toxin genes in E coli
using PCR technologies.

There are two kinds of E. coli that cause disease, others do not cause
disease and it is important to distinguish between them.  There are three
biomarkers for toxin genes in E. coli, for human, pig and cattle.  A
biomarker for bird feces is pending.

Ribotyping of E. coli automatically generates genetic fingerprints.  It is
a useful tool for tracking outbreaks and for identifying human and non
human pollution. E. coli cells are lysed and release their DNA which is cut
into fragments using special restriction enzymes.  The fragments are
separated by size through electrophoresis and run through a gel.  Because
these fragments have a charge they will travel at different speeds and
intensity through the gel.  The pattern of the fragments in the gel is
transferred from the gel membrane, mixed with a DNA probe and
chemi-luminescent chemicals to produce a visible band pattern from which a
DNA analysis can be made. The computer software can do isolates in 8 hours.

Eight  human pathogens have been collected from all over the state.  Some
are the same but the animal isolates are all distinct so that they can tell
which animal they came from.

In order to do source identification they need to have a  database of known
patterns they can work from to compare with the sample they are testing.  A
small sample size is not as accurate as a larger sample because it is prone
to bias. The process is expensive. The cost is a minimum of $100 per
isolate and some want to screen 500 isolates.

Recent published Ribotyping studies indicate that correct classification of
samples is in the 90% range, but when all sources are grouped the percent
came down to 74%.

In a park service study half of the E. coli were not identified, however
they were able to identify seven waste sources.

In summary she said that all source tracking methods have strengths and
limitations, we need better criteria and the methods continue to evolve.

A tool box approach to the problem is advocated, using watershed
evaluation, key monitoring parameters, strategic monitoring sites and
microbial and chemical tracking tools.

Cephalosporin resistant E. coli
Patricia Winokur, Dept. of Internal Medicine, Iowa City

A project studying Cephalosporin Resistant E coli in Iowa started in 1999
and has continued for three years.

84.2% of antibiotic use is for livestock and only 12.8% for human use.  In
livestock, therapeutic uses account for  24.5  million, therapeutic uses, 2
million.

Data around the world suggests that antibiotic resistant organisms are
being transferred from animals to humans.  In Europe Vancomycin resistant
Enterococci were found in animals.  Then humans were found to be carrying
the same antibiotic resistance.

A story in the New England Journal of Medicine told of a Quinolone
resistant Campylobacter in Missouri from poultry products and humans with
identical molecular typing.  There are absolutely identical products in
poultry products, so it has been shown that these bacteria can transfer
back to meat products.

There are now Quinolone resistant salmonella .

These bacteria can be transferred by direct contact between animals and
man.  There is also food-borne transmission of resistant bacteria, and
environmental contamination.

How the environment may play a role is unknown Data is being acquired to
trace this transfer from the farm to the human.

Tetracycline resistance has been found in swine production facilities.  The
resistant genes have been identified in lagoons and traced to ground water
up to 250 miles downstream from the lagoons.  The resistance has also been
found in soil bacteria and groundwater is a potential source of transmission.

In 1999 Cephalosporin resistant E. coli and salmonella were found in hogs,
cattle and humans.  There are also multiple additional antibiotic
resistances.

A map of E. coli isolates shows that they are found all over Iowa.  There
is a clustering of human isolates in  North East Iowa and some in or near
the Quad Cities.

All of these isolates had the CMY2 resistant gene.  It is present in
plasmids which are easily transferred from organism to organism because the
plasmid doesn't have a species boundary.

This same human Celphalosporin resistant isolate has been identified in 14
different states.  Retail ground meat products with Cepahlosporin
resistance have been found in Washington, D.C. stores

In addressing the question of whether Iowa waterways are  a source for
transferring resistance from farm to farm, she collaborated with Nancy Hall
and the Iowa DNR.  They sampled 62 sites, concentrating on eastern
Iowa.  They found that between 2 and 7.1% of the E. coli  were
resistant.  The prevalence of resistant bacteria in sick animals is 15.6%.

Over 70% of the resistant bacteria encode the CMY2 gene and determined that
it is being spread through waterways.

These bacteria demonstrate co-resistance.  In addition to being resistant
to Cephalosporin, they are 100% resistant to Chloraphenicol,
Sulfamethoxazole and Streptomycin.  They were resistant to other
antibiotics at a lower percentage.

Then they began the molecular typing of CMY2 plasmids.

They want to know how persistent the contamination is.  They plan to target
sites with multiple episodes and go back and sample on a daily basis.  They
would like to find particular facilities and look at farm soil samples, and
learn what the climatic events were.

Conclusion: Cephalosporin resistant E. coli is present in Iowa's surface
waterways.  The expanded spectrum Cephalosporins are the drugs of choice
for empiric therapy of gram negative infections
Some CMY 2 organisms are now resistant to most classes of antimicrobial agents

Food-borne transfer of ant microbial resistant organisms continues to be a
concern. Water contamination may be an important mechanism from spreading
this resistance from site to site.

A question was asked about fish. She said she does not know about fish but
would expect it to be in the gut. The reason it is in ground meat is
because of fecal contamination.  With non-ground meat if you sear it on the
grill that will kill it.

Fresh manure will transfer this to the water system.  If it dries out it
will die.  Getting rid of it will be difficult.  In the absence of
antibiotics they will persist for a year.

Nitrate in Drinking Water - Research on Health Effects
  Peter Weyer Center for Health Effects of Environmental Contamination
The University of Iowa

The highest concentrations of nitrates in Iowa streams is among highest in
the US in 1996-98, especially in shallow aquifers.  There is a greater
problem in agricultural areas than in urban areas, and more problems in tap
water.

Among eight hundred and fifty six private rural wells that were tested,
eighteen percent exceeded safe drinking water levels.  Thirty five percent
of wells less than 50 feet exceeded the standard.  One hundred and thirty
thousand rural Iowa residents use well water with high nitrate.

The sources are fertilizers, animal waste, septic systems, and water
treatment facilities.  It comes from the diet, green leafy vegetables, as
well as from water.  Drinking water contributes fifteen to eighteen percent.

There are health concerns because nitrate converts to nitrite which
converts to NOSs.  These compounds are potent cancer causing agents and
ninety percent of them have been shown to cause cancer in laboratory
studies.  Most are mutagens but are not causing malformations in fetuses.
(Seems to be contradicted by his next statement.  Oh, well.)  The non
cancer health outcomes are goiter, malformations in newborns, miscarriages,
chromosomal damage, risk of diabetes. neural tube defects and blue baby
syndrome.

As to cancer there have been mixed findings both internationally and in the
U.S. Stomach, bladder, brain, ovary, non-Hodgkins lymphoma have been shown
to be caused by nitrates, and the cancers that have been shown by other
studies to have no link to nitrates are stomach, bladder, oral cavity and
non-Hodgkins lymphoma.  It is tough to say whether it is a problem with
specific cancers in Iowa.  No correlation was shown for many kinds of
cancer, but bladder cancer was confirmed for rates not higher than 3 parts
per billion.  Then, again, another study showed no association
.
Conclusions: his research suggests it is probably wise to leave the current
standard for nitrate exposure where it is rather than raise it which has
been the subject of debate.
Nitrosamines are a new concern.  NDMA (nitrosodimethylamine), a recognized
carcinogen is formed in surface water treated with chloramines and
disinfectants.  Thirty percent of water treatment facilities use
chloramines to avoid toxic by-products associated with chlorine.

Other precursors may be able to promote the formation of NDMA as well, for
example, water treatment resins, so water supplies with excess nitrogen may
be at risk. NDMA may be forming out in their distribution systems.