Citation: Mudd A (2005) Did Glycopeptide Use in Animals Result in Hospital Infections of VRE? PLoS Med 2(11): e383. doi:10.1371/journal.pmed.0020383
Published: November 29, 2005
Copyright: © 2005 Anthony Mudd. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Competing interests: AM was a consultant advising the International Federation for Animal Health representing the Global Animal Health companies.
As one of the persons involved with the development of avoparcin for farm animals, I have followed the discussion on vancomycin-resistant enterococci (VRE) and its potential transfer from animals to humans over the past decade. What a pity that the authors of this PLoS Medicine Policy Forum  did not reference a recent review by Wassenaar  that comprehensively discussed this topic. In this review, evidence is presented to show that VRE infections in humans have actually increased in the European Union since avoparcin was removed from the market. Other data show that whole-genome typing methods separate clinical VRE strains from animal or nonhospitalized human strains.
The conclusion of the Smith et al. article  that a correct decision was made to adopt the EU “precautionary principle” and remove avoparcin from the market is surprising, as this is contrary to the opinion of the independent EU Scientific Committee for Animal Nutrition, and since a quantitative risk analysis, as suggested by the authors, could not conclude a relationship between glycopeptide use in animals and incidence of clinical infection in humans.