I just want to share what my intentions are in in this in this time that we have together. I want to share a little bit about my story and then I want to I have a burden to help pastors that have to deal with prophetic people. You love me already, don't you? You love me, you love me and please don't be offended it's totally on purpose but prophetic people can be strange and yet we pastors need you and so hopefully I'm going to lend some language as to what's healthy, what's biblical, what really really isn't biblical, what do you do when somebody shows a church and says you know I'm a prophet, I'm a prophetess, I'm prophetic, we don't know how long we're going to be here but as long as we are we want to bless the church. What does a pastor do with stuff like that and because it happens doesn't it okay and so I are one and hopefully I'll be able to help a little bit. So let me first kind of explain how I came into this because I wasn't raised in the church, I was raised Polish Catholic on the west side of Grand Rapids and on my west side peeps, yeah, cabas in sauerkraut and all that's good and holy in life. So the first church service outside of the Catholic Church I ever went to I was up till five in the morning snorting coke with my buddy who a few years after I got saved went on to rob nine banks in the Grand Rapids area he was called the Lucky Noontime Bandit, go ahead look him up my buddy and tremendous influence in my life and so I get saved out of the Catholic Church boom into an assembly of God Church Large AFG church in Grand Rapids and growing up in the AFG you know we'd see the gifts of the Holy Spirit and stuff like that but did not see a lot of prophetic ministry and I'll never forget the first time I was exposed to any prophetic ministry at all it was a minister named Dick Mills how many have ever heard of Dick Mills before just I just thought who is this guy you know that's calling people out in the congregation and how does he know this stuff about them how does he know what they do for a living how does they I was fascinated by it and here I am I'm sitting in the front row of a choir loft same choir loft that I've met my wife in and I'm sitting in the front row the choir loft and Dick Mills gets done calling people out of the congregation and he sits down and he starts writing on a piece of paper and he turns back to the choir and he and he gives it to the guy next to me and the guy goes for me and he goes no no no the one next to you and he gave it to me and it was the first prophetic word that I'd ever received I clung to those verses that he gave me still are critical in my life today but you know that was kind of like my my introduction to prophetic ministry and then I I became a youth pastor in Grand Haven for three years and out of all of the churches that I could be in in our network of churches at the time the church that I was on staff at was a church that was very given to the prophetic and our network at the time wasn't yet my pastor was and so it offered me an opportunity to grow and to flourish and he had great grace for me and and I I get it as a as a senior leader if you're how many senior pastors do I have any lead pastors do I have in this room all right all right all right all right my pastor would say John when you would say that God was showing you something I would cringe and uh and I'm sure that I'm sure that some of you lead pastors right now oh I know the cringe the cringe is real the struggle is real and uh and so I I totally totally get it and my heart goes out to you but if we ever needed strong healthy prophetic ministry it's now and depending on what kind of school you came out of um prophetically um you might just see things differently I I I was kind of raised in a in a prophetic environment in in Grand Haven where you know presbyteries were you know getting the chair and about 10 20 sweaty hands are on you and you know if you got anything just give it and and you know we just kind of we let it fly and by the way pastor les beachham from Nebraska Omaha Nebraska is teaching on presbytery if you want more language on what that is please get his notes he's an amazing amazing bible teacher and so right now simultaneously he's teaching on prophetic presbytery and what it is and what it's all about pastor lee uh calls me and um he uh he said um you just need to get down to the church Saturday night and uh and I said what he goes we're having we're having presbytery and I go what do you mean you're you're you're having I go presbytery is like a spontaneous thing you're getting the chair he goes no no no no he goes you've never seen this before he goes I want you to come I go man I don't John just shut up and get here Saturday night and I said all right and he goes sit in the front row and that was the first time in my life I ever saw healthy practical prophetic ministry under pastor tom lane um from gateway church and the team that he came with his son was with him um pastor marcus uh was also with him that time and I sat there kind of could this be real could I you know is this the unicorn you know that you know none of us have ever really really seen could there really be healthy prophetic ministry like this I am so doggone grateful today to be standing in front of you and the healthy prophetic ministry that the radiant network provides I'm so grateful for the influences of pastors tom lane Wayne drain lauren covarrubias um jimmy evans the tremendous influence that these men of god have been on pastor lee and it's because of pastor lee that I'm here and able to share these things with you so so that being said I know that um that prophetically things can be kind of out at times and and I get it all I knew when we started our church 25 years ago we're celebrating 25 years this year um all I knew thanks thanks thanks the secret to success I've got it for you want to write this down don't quit there you go if that it was worth the price of admission just for that so um but back in the day I uh there was no real template I knew that I was prophetic and that's about it and so we would do you know like prayer lines at at the end of services I I found myself praying over the same people all the time and I I I I got kind of frustrated I got kind of discouraged I I felt like I was a like a right at cedar point that was just being taken over and over and over again you know I even had this this person that would come up to me pastor john you got a word for me and I'd grab my bible I got a bible full of them um you know pick it up and they were just I felt like they were just kind of pulling on my gift the same people all the time and so I really discouraged I kind of tabled my gift I just kind of focused on the on the growth of the church and uh and then I thought no I need to embrace who I am and so I I approached Lance Wall now one time and I said do you know any prophetic ministry that I could bring to our church and he goes yeah I do so I bring these this couple to my church and she's prophetically dancing and then I got people that are pulling out flags and banners and and uh and I I just thought I would I'm prophetic but would I go to this church um I'm the pastor would I go to this church and until pastor lee you know presented healthy prophetic mystery I didn't even I'd never seen anything like this is normal they're not even touching them they're not even this is this is crazy and so I want to I want to help um because at our church we've got a lot of of prophetically gifted people but if you don't offer an opportunity for them to grow then they're going to grow on their own and that might not be pretty and and and then you're going to have to try to steer them and so I want to offer I want to offer some some context for um biblical healthy prophetic ministry we're going to look at maybe some Old Testament verses that you haven't seen before and uh and so you know hopefully I help and then I'll try to open it up for for questions at the end but as I'm as I'm looking at the Old Testament and you're going to be shocked at how they tie together concerning the prophetic concerning prophecy and prophets um it was very much community-based very community-based I I I struggle with the the prophetic people that see themselves as these lone guns that roam from church to church you know on a you know you know they and they they're just they're ripping off these prophetic words without any accountability with seemingly no desire for community I I I struggle with that I don't see a biblical pattern for that I I just don't you know I don't know how good I'm going to do it sticking to my notes but um so um let's just you know for for some language and for some context let's just settle something first and foremost no one has the gift of prophecy it's not yours it's the Holy Spirit's and so when someone says they have the gift of prophecy you're trying to lay ownership to something that isn't even yours it's a gift to the Holy Spirit it's not yours it's not resident or dormant in anyone um you are used in the gift of prophecy you're used in it and it's at the Holy Spirit's discretion you know not yours and so if he's using you in that then man keep a tender heart keep a submissive heart um but it you you don't own it it's not in you it flows through you as the Holy Spirit wills for the prophet of all and so I want to show you um some verses maybe you've never noticed before go to you're going to find it odd talking about the prophetic go to the book of Ezra so before you get to Psalms Job go to the book of Ezra chapter 5 I'm going to help me get this all out so that when I leave I feel like I got it all out look at Ezra 5 2 and I'm going to tie this into the New Testament and I'm going to show you how it's very very consistent um even though we're talking like two different really you know grace's Old Testament New Testament as you all know the Holy Spirit wasn't even given in the Old Testament but there were prophets in the Old Testament it says in Ezra chapter 5 verse 2 it says then Zerah bubble the son of Shealtel and Yeshua the son of Joseph that arose and began to rebuild the house of God that is in Jerusalem and the prophets of God were with them supporting them go to chapter 6 and look at verse 14 it says and the elders of the Jews built and prospered through the prophesying of Hagia the prophet and Zachariah the son of Edo they finished their building by the decree of God the God of Israel the decree of Cyrus and Darius and our desert sees the king of Persia noticed how the prophetic ministry how prophets were supporting noticed how they helped build that's very very key language when it comes to to prophetic ministry we know from 1 Corinthians 14 verse 3 that prophecy speaks edification exhortation and comfort well what's edification what what does it mean edify means to build it means to build up that's why when someone speaks in a tongue they edify themselves they build themselves up when someone prophesies they edify the whole church and 1 Corinthians 14 is an amazing chapter because you are going to find over and over and over again how the gift of prophecy builds and I love let me just give you verse 32 in the new living probably words it better than any and this is kind of my standard verse that I use for for prophetic people that act like when the when the Holy Spirit comes upon them they they just can't control themselves this is how I am when the Holy Spirit comes on me and I just want to offer a scripture scripture being our guide right 1 Corinthians 14 32 in the new living says remember that people who prophesy are in control of their spirits and they can take turns I'm sorry that might not work with how you feel things should go down but I'm sorry I'm not sorry because you're you might be freaking out your spiritual leadership and and they and they want to use you and they see that the gift on you is genuine but what I had I had a person come to me one time in a service and Pastor John I believe I've got a word and I and we have kind of a check and balance at our church because we just want to make sure that what goes forth is healthy and encouraging and I said well what's your what's your word well I don't know I'm just going to get up there and I'm going to start worshiping and in front of the congregation and then the word's going to come I said well why don't you go back to your seat and worship and when the word comes come back to me because what you're doing in front of everybody doesn't make sense doesn't make sense so let me let me suggest something I remember Mike Bickel saying years ago and I thought it was so good he said there are things that I do when I'm all alone with the Lord that feel right to me and the Holy Spirit I don't know if there's a a whole lot of biblical context for it but I would never take it out in public he says there are things that I allow to take place in the congregation that I wouldn't necessarily bring on the platform I think there are respected areas where things might be able to fly and things might be be given a little bit more room but I think sometimes we could be trying to drag our bedroom out into the public and I think there are certain levels of intimacy that everybody doesn't need to see I don't know about you but I love my wife but on Sunday morning in front of the congregation I'm not making out with her in the front row so I the Bible says he's brought me into the king's chamber doesn't say that the king's chamber king's chamber was brought out into the public in the song of Solomon and so I think there is maybe the way that we we experience God I think that that could be different from the way that we hear from God and it could be different from the way that we're used by God and so how you experience God man you could be you might be balling you might be shaking you might be in a crumpled mass in the front of the church praise God for the work that he's doing for you in that moment praise God for the way that that he speaks to you and and how you hear him but when it comes to giving a message from God the Holy Spirit's weird not weird and so we shouldn't be weird and so I don't know if it benefits any anyone for you to be praying loudly in your prayer language before you come and give somebody a message or for you to be shaking or for you to be balling like you're out of control for it is about them you're coming to them with something the Holy Spirit's given them and you want to see that you deliver that you're a messenger you're a messenger and so in our in our church I've I've had to tell people do you do you have to do that can you can maybe ratchet it down a little bit so that the message is given opportunity because I guarantee you they're not going to hear a word you say and they're just going to remember how frightening you were to them and how intimidating you were to them so it's one thing to be touched by God in a significant way it's quite another to deliver a message given by God and ask yourself ask yourself what's more important you or the message that the Holy Spirit's given you what's more important I need to know that the people are going to get that I mean I I want to know that they're not going to remember me they're going to remember what God spoke to them and I think sometimes we we want so badly to be to be you know you know recognized and you know and and was that good for you man just just give them what God gave you and try to get out of the way as soon as possible so that they can be thinking about what the what the Lord has done when we have prophetic presbyteries in our church I'll tell folks hey you know don't pray for everybody because there are a lot of people that want to be ministered to man just give them work get more now if it's kind of serious and can I pray for you ask permission can I pray for you but I it's very very important that if you're going to be used and prophecy that you that you handle that message as it came from God and you treat it that way and you give it to people that need to hear that message you have no idea what they're going through you might not even have a clue as to what they're going through but it's so important that you get to get that to them and deliver the goods to them I'll also say this not everybody who prophesies as a prophet and honest it it doesn't matter what they think or say if if that was a case and everybody who evangelizes is an evangelist then then everybody whose pastoral is a pastor everyone who teaches is teaches as a teacher Ephesians 4 says that he gave some to be apostles prophets evangelist teachers and and they're likened to the to the fingers on a hand the prophets the finger pointer and he points things out and he speaks for the heart of God the evangelist is a middle finger he sticks out from among the rest the pastor is a ring finger he's married to the church the teacher is the pinky he brings balance and the apostles the thumb because he touches all of them pastor Lee is an apostle and he touches all of them he touches all of them but it says he gave some he gave some so the prophet is an office given prophecy is a gift given and and we don't own them I am occupying an office for a time and for a season and it's not mine and I need to treat it as Jesus gave it he gave some he gave some to be apostles prophets pastors teachers evangelists the Bible says but if all prophesy in 1st Corinthians 14 24 so once we've been baptized in the Holy Spirit and if you have not been baptized in the Holy Spirit well Pastor John didn't I get the Holy Spirit when I got saved well sure you did absolutely but it's like a drink compared to immersion where you're you're going swimming and so if you've never been baptized in the Holy Spirit please hang around afterwards I would love to pray for you and see that you baptized in the Holy Spirit but once you've been baptized in the Holy Spirit then the gifts of the Holy Spirit can now begin or they can be given opportunity to operate and to function in your life so Matthew 311 says uh John the Baptist said I've I baptized you with water but there's one coming after me who's mightier than I he'll baptize you with the Holy Spirit and with fire he's talking about Jesus Jesus is the baptizer and the Holy Ghost okay and so Acts 19 1 through 6 well let's let's I'll go there I'm doing okay yeah I'm doing all right Acts 19 I thought this was so good and it happened while Apollos was at Corinth Paul passed through the inland country came to Ephesus there he found some disciples disciples so these are people that have invited Jesus into the heart these are disciples and he said to them did you receive the Holy Spirit when you believed how unusual how unusual that he would ask that did you receive the Holy Spirit when you believed and they said no we haven't even heard that there is a Holy Spirit and he said in the what then were you baptized and they said in the John's baptism and Paul said John baptized with the baptism of repentance telling people to believe in the one who was to come after him that is Jesus on hearing this they were baptized in the name of the Lord Jesus when Paul had laid his hands on them the Holy Spirit came on them and they began speaking in tongues and prophesying there are about 12 men and all three different events here we're talking salvation we're talking water baptism we're talking spirit baptism they've been likened unto the Exodus the Exodus leaving leaving bondage in one kingdom for another the promised land you know salvation spirit baptism walking through the parted sea and or water baptism walking through the parted sea spirit baptism pillar of cloud pillar of fire he'll baptize you the Holy Spirit and with fire so those three have been likened into the Old Testament as to the Exodus so I I think three things are maybe foundation stones for stepping out in prophecy I call I'll call them the ABCs I would say the ability to focus on another prayer so what will often do at our churches I'll just pull somebody up and I'll say what's God telling you for them it is amazing how God can begin to speak to you if you focus on someone other than yourself you have to be able to focus on others to be used by God if you don't have a heart for others then are the gifts of the Holy Spirit just for you when you're all alone in your prayer closet I mean how many of us operate in the gifts of the Holy Spirit when we're all alone so just the ability to focus on somebody else just just I I'm trying to get to point Pastor Wayne drains been kind of pushing me to do this but I'm trying to get to the point that I could be open to God using me like that even as I come up in the pulpit on a Sunday and it's happened a few times just as I've been open to it or I'm worshiping in the front row and God's putting somebody on my heart and I know that they're there in that service and that congregation and so I don't know about about you but I need to go give that message to them before I can preach I can't even think about my message because God's given me a word for somebody and just to go to them and to give that the second thing I would encourage you to do is just boldly step out just boldly step out and maybe you know touch base with your with your pastor and just say I think God's beginning to speak to me how would you have me handle this and and you know hopefully your pastor's encouraging you in that and he wants you to step out but I love community when it comes to prophecy because it's biblical we we know in scripture that in First Kings 18 Obadiah had a hundred prophets from Jezebel we know in 2 Kings chapter 2 you'll notice four times sons of the prophets were mentioned notice how that was community-based it was community based and we know that the sons of the prophet approached Elisha before Elijah was taken up and they said don't you know your master's going to be taken from you so they knew them so if there were sons of the prophets then who were the fathers there must have been some kind of mentoring must have been some kind of prophetic community going on must have been and so I I think it it really really healthy that prophecy is in it's in community it's not like these lone wolves that are pulling people off to the side and getting there's I like words given in pairs or or threes and instead of just somebody you know because how do I know that someone's intentions are good you got a you know a good-looking young single guy and he's always getting words for the ladies how do I know you know we want to make sure that there's accountability accountability you're going to notice in first Corinthians 14 that prophecy is for building up and it's for edifying the church versus three through five versus 12 and 31 it all speaks about edifying the church I struggle with someone who's prophetically gifted who seems to really have no heart for the church they just want to they just want to cut it loose and and rip it and then you know they could be gone in a week or two and down the road you know because I guess the cloud lifted glory cloud and they're down they're down the road I don't understand not having a heart or for the body of Christ I don't understand not having a burden for the body of Christ why why is that so I believe a prophet isn't someone who bounces from church to church with little to no accountability or or no desire for community you know I I I think that you're to grow in your prophetic giftings and so how do you do that and I think as pastors we need to provide an atmosphere for that and I'm so grateful for this network because of that and I believe that the prophetically gifted can can give the impression at times and and hopefully you're not one they give the impression at times that you know this is this is who I am and this is what my gifted I'm not looking for a church to attend I'm looking for a throne to ascend and I really really I really really think that pastors need to come alongside of these folks and say you know what I recognize the gift on your life and I can help but can you yield and can you submit and some of the godliest most prophetically gifted individuals that I've ever met are some of the most humble dudes pastor Wayne drain such a humble guy pastor Tom Lane such humble men such humble men you wouldn't know who these guys are if they weren't standing in front of you and talking to you so unbelievably humble and there's something about humility that just says that oh my gosh I love these people I can work with them there's a wonderful gifting on their life and yet they have no problem yielding it or submitting what if your pastor says I don't think it's time for that right now I mean I've been in the pulpit working towards an invitation towards the end of the service and having people walk out and come to me I don't even want to know what the word is this is not the time right now this is not it and if you were sensitive at all to the Holy Spirit you would sense that that we're we're bringing this in and we're going to throw the net out here in a minute and I could really use your prayers right now I believe the foundation of healthy biblical prophecy is love edification in community biblically love edification community Old and New Testament alike and where those things are absent and you got these lone guns I mean we should all get them I remember Laverne and Shirley and Lenny he had a coat that had the lone wolf on the back of it I think sometimes we know let's make a bunch of shirts these are lone wolves you know we don't know how long they're going to be here they're just going to you know grip it and rip it and then they're going to be down down the road I we need to have some kind of culture for the prophetically gifted people to to flourish life groups what a wonderful opportunity you know just at the end of a life group anybody got any prayer requests you ask for prayer requests and then hey why don't we just wait on the Holy Spirit for a minute and see what the Holy Spirit's saying what a great opportunity just to lean in just to lean in and just do that I mean how hard is it what opportunity are we offering and I understand pastors that it can be intimidating but what opportunity are we offering people to grow I'm so grateful that I had a pastor that he you know yeah we had two three hour services and and and everything but he allowed me the room the room to grow and he recognized a gift in my life and and so I I just want to I want to encourage so here are some dangers that I've seen in those that are used prophetically I've mentioned the one I have the gift of prophecy when that is the thinking prophecy becomes one's identity and not Christ you know why don't you come up and tell me that you have Jesus you know why it and again it's not your gift you don't own it it's not yours it's not yours my my sons can borrow my car but it's my car and I would appreciate it if they ever want to use my car again that they treat it like it's not theirs and like it's mine and if you really love your dad maybe you could put a little gas in there after you after you and so how are we treating the Holy Spirit's gifts are we treating them like there are I can just behave any way that I want to that is not God honoring Revelation 1910 says the testimony of Jesus is the spirit of prophecy it should all be about Jesus all be about Jesus if it's not about Jesus what is it about and consistent with scriptures is that you can prophesy your own imagination this is being recorded okay I hurt for all of the prophetic voices that went on record and said that Trump was going to be president I hurt we've got to be able to separate our desires and our wishes and our wants because it's not about us it's about what the Holy Spirit's bringing what's the whole what the Holy Spirit's giving and that is what we must give and you would do well to remove as much of your flesh from that as possible don't tack anything onto it just just give what God's given and you have no idea it could be as simple as man the Lord just really wants you to know how loved you are he loved you so much you might think oh that's so basic I've seen words like that given and people crumple when they just start balling you have no idea what somebody's going through no idea no idea and and the more you begin to step out and and you're you're gonna have to step out you're gonna find out oh my gosh that's that encouraged them so much because that's what prophecy is all about edification excitation comfort that word comfort it's a word you don't probably see too many word studies on the the root of that word it we we get this sense this sense that that word comfort means to like some some some balm or some you know it's much stronger than that the the the Latin that it came from is for us and it means to fortify it means to encourage to speak courage when you're comforting somebody hey come on we can make it through this come on we can do this God's got you come on hasn't God delivered you before hasn't God set you free before come on so prophecy can be can be very strong but it's very encouraging in its essence it's encouraging it's edifying it builds up doesn't tear down I've been in I've been in prayer meetings before where people believed that they had a word from the Lord that someone was going to try to take the pastor's life that's not prophecy and as a pastor that would not be very encouraging and that wouldn't be building me up I'm just trying to help I believe that people that struggle with with submission think that the prophecy is theirs you you if it's God you can't be afraid you bring it to your spiritual leadership late before them I believe I have a word this is what it's about whatever you want to do with it pastor whatever you want to do with it my bible says humility proceeds honor humility goes before honor I have seen prophetic circles grow smaller and smaller because there's almost this demand for for recognition and I believe influence is lost as a critical spirit is adopted bordering on Gnosticism and I and I and I get prophetically gifted people saying well you know pastor never never listen see well man just lay it before him and and and let him chew on it I've had people you know come and give me words into service and I'm about ready to walk up and oh man that's God you know and someone just came to me and said that there's a word right now we're just going to pray we're just going to open it up right now we're just going to lean into that right now seeing so many amazing things happen in moments like that so healthy prophecy focuses on others and not self focuses on others and not self is submitted and not prideful you know it breaks pride quicker than anything accountability think about how much hidden closet habitual sins are rooted in pride the man struggling with pornography that doesn't want to have an accountability partner he's in deep weeds isn't he accountability breaks pride breaks pride pride wants the kingdom humility serves the kingdom my bible says in 1st Corinthians 1432 that the spirits of the prophets are subject to the prophets why can't you lay it out there for other prophetically gifted people to look at that and say man that really really is God that's really the Lord why can't we do that biblical prophecy screams love edification community accountability it screams it biblical prophecy does and if you're looking for it you're going to find it from the old to the new you're going to find it in the Old Testament before the Holy Spirit was given and in the New Testament 1st Corinthians 14 just read that chapter it is loaded with how the Holy Spirit's heart is for the building up of the church the building up of the body of Christ you'll you'll notice the context of prophecy over and over and over again is building up building up building up it's edifying it's encouraging it's breathing life into again and again and again I felt today that coming in that there would be folks here that are are struggling with prophetically gifted people really felt that on my heart and what do you do when you've seen God use somebody and you know that it was a Lord and yet there might be something about that person that just says man they aren't submitted man they don't have the they don't have my heart they don't have the DNA of this church they're not embracing this vision they're not you know what do you what do you do with people like that yet you sense a genuine and a bona fide gift what do you do what do you do what do you do you pastor and pastor that's what you do you love on them and say man God uses you why don't we meet if we're to grow in the grace and knowledge of our Lord and Savior Jesus Christ 2 Peter 3 18 don't you think that the giftings of the of the Holy Spirit and our ability to be used in those don't you think that that's a part of our growth that says to grow in the grace and the knowledge of the Lord and Savior Jesus Christ what if there's a grace on your life you it is it's it's not a difficult thing for you just to to ease into giving prophetic words what what if that's a grace on your life how are you going to grow in that and pastors how are we going to embrace these people I I think of the apostle Paul there were two individuals in his life that were that were that were powerfully used by God Ananias who came and laid hands on him and the scales fell from his eyes and the Barnabas that encouraged him put his arm around him and said no no no no this guy's legit I think you need both you need those that are going to lay hands on and you need those that are going to put put their arms around you and I really really believe that pastors we cannot be intimidated by prophetically gifted people but they should be willing to to come under and to recognize you as a spiritual authority in their life and I don't care how much older they might be than you you can be a father to them probably one of the most difficult things for me to realize as a young guy starting a church was that I was a father in the body and I'd have these older men and they would be hanging around me and I and it would be like awkward because guys were not the best communicators in the world you know and so these guys behind I'm like what is his deal oh my gosh I'm a dad um and the and the light kind of went on and we need we need healthy secure pastors that will that will speak in to the lives of prophetically gifted people we need him in the body we need him in the body we need him and so why don't I you know open it up for any questions right now and then I want to want to pray for you at the end yeah okay great question the question was for the recording you know have begun to lean into this where do we go how can we foster you know people prophetically I'm going to recommend a book it's what we use in our prophetic classes we use this book as a template it's called he still speaks by pastor Tom Lane and pastor Wayne drain what a great great but in fact pastor Wayne drain has now come out with with a he still speaks to children so we haven't graduated to our children prophesying yet but we have our youth and our youth are are now speaking over each other and they're it's it's been amazing so we use that book as a template and we have a prophetic class class and then at our prophetic class we'll we'll go through maybe like a chapter of the book and you could just go through the book and you can kind of pull out the things you want to focus on and then at the end of every class we'll have someone come okay sit in the chair okay who's getting anything who's getting anything and and so they grow both with uh something that they can have in their hands you know a physical you know curriculum of sorts and then they're they're involved in activation so they're they're stepping out and honest you know you would be you'd be well why don't we just do this right now so come here my dear what do you feel god's telling you right now notice immediately you're focusing on her how you're leaning in could be a scripture could be a word could be a picture servant leader grace intercessor god's grace all over you beautiful daughter gosh this is so debilitating and discouraging these words that are coming forth i don't know why we would want this in the body um it's it's not i'm sorry my sarcasm the youngest of seven kids it's just comes natural um you can sit down not hard focus just an ability to focus it's not a difficult difficult thing difficult thing i just hear the lord say that there are things that you've been weeping over in your prayers and that god's going to answer those tears virgin said that tears are liquid prayer and i just saw you weeping like almost like a portion of your time alone with the lord was spent in in tears and there are burdens on your heart and that god is going to answer those tears and sometimes those are the purest form of prayer and so rest assured god's in this he's not abandoned yeah he's not left you okay um okay so the question is um i'm young in this and how do i use discernment and knowing when to go to somebody i'll i'll answer this in a couple ways there are times when you might discern something about someone and that's not necessarily something you go to them about and just log that and keep in mind that part of the Holy Spirit's ministry is to call to your remembrance and so what i'll do many many times i'm beginning to get a to get a word and and i i don't feel it strong enough to maybe jump out i'll try to to push it away i'll try to suppress it because i know that if it's the Holy Spirit it will dog me it'll chase me down the Holy Spirit's the hound from heaven he's been called he will chase you down and and then if if you know that you are supposed to do something it won't go away but i would try to make it go away just go back to worship or or go back to taking notes in the service or whatever and if it's still lingering then go up to those people and just say i believe the Lord's speaking to me about you could i pray for you and and and it just isn't easy and as natural a way as possible don't come up to him start frothing at the mouth and say the sayeth the Lord you know with a cowbell in your hands um so um no do not bring the cowbell um delin all in about 15 20 seconds so what so our front row um you know our leadership uh me my wife our elders we try to have our leadership sit towards the front because our congregation needs to see our leaders worshiping the Lord too they need to see and so um they'll come up i think i got a word okay what is it or could we hold on that it sounds like a little mini sermon there can we wait can we can you sit on that a little bit longer and who knows maybe while i'm preaching i'm working towards an invitation at the end of the service you know when someone came to me before the uh you know before i got up here and they gave a word but some kind of check and balance i i don't know if i'm necessary and i'm please i we're all growing so i'm not saying i got a corner in anything i don't know if i'm a big fan for an open mic depends on the word to you know like you know i i i see the Lord sending you to africa maybe some follow-up you know you know so so um anybody else yeah yes i'm sorry you sinners great question beginning in prophetic ministry in a baptist church how do we navigate that with people that aren't open to it i'd say language is really really important um hey we're we're we're gonna be holding prophetic presentry what the heck is that you know hey we just uh we get together and we just kind of wait on the Lord and we allow God to use us and speak through us notice a difference it's a lot more inviting and it's not so intimidating you know um i'm a prophet and i am just going to unload on you what God gives me and many times seen fire come out of my mouth and off the ends of my finger so the language that you use the language that you use can be inviting and just get them get them into the water who cares if they're in the shallow end you know to start just get them in the water have you ever been baptized in the holy spirit with the evidence of speaking in tongues have you ever um could we pray for that could we are you open to that you know um and i'm not saying that tongues is the end all be all evidence but more often than not it is um so i mean let's uh you know if there's anybody that that wants more not a determiner as to whether we go to heaven or not but doggone it man it'll like put bullets in your gun that you didn't have before and god wants to use you kind of thing sure sure so um nine gifts of the holy spirit first Corinthians 12 um a word of knowledge has to do with the past or the present word of wisdom with the future and a prophecy is speaking like the heart of the heart of god for a moment heart of god for a moment and so and and and prophecy can have elements of it but i i had a word of word of knowledge um saw you um praying and weeping and um god's answering those so word of knowledge past or present word of wisdom future prophecy is you know if you if you study it out it literally talks about a bubbling up in the in a moment you're speaking the heart of god in a situation anybody else yeah matt great question um i remember how i talked about how a prophet is part of the five-fold ministry and the bible says that the five-fold ministry and Ephesians four is for the equipping of the saints for the work of the ministry if someone is is is in the office of a prophet they're going to be in full-time ministry somewhere they're going to be getting groomed for it because they're an equipper in the body okay and so i would say that a corrective word like that probably has a tendency to come more from an equipper in the body um you know because we know that all scripture is profitable you know it can rebuke it can correct it can and so they're probably someone that is regularly ministering the word if it's someone that's young and they're prophetic gift yeah it might be tainted you know a little bit and so as a lead pastor have the courage to say um you know i don't think that's a word for the whole body i think that might be something that god might be speaking to you about personally i i like to share the story years ago um pastor ron mclean my wife and i we all grew up uh pastor lee we all grew up in and uh and you know g r first and our pastor was very very good at knowing whether something was from for a word for the body or not and uh you know one day you're in one of those lulls and in those moments where you know a word could pop you can just off feel it there's an anticipation something's about to break somebody's got something we'll even ask in our church man if somebody has something right now and we'll just ask well in this moment this this this gal yells out thus sayeth the lord just as there are many various kinds of chocolate cake and uh and pastor and pastor said sister sister sister sister i believe that's a word just for you i don't believe it's for for the whole body and my buddy's in the front roll the choir laugh and he gets this confused looking at say five-year bible college student confused look in his face just how many kinds of chocolate cake are there i laugh out loud and pastor turns around at the choir laugh and i'm just i'm just looking down so um a corrective word like that okay so let's say someone's got a bona fide bona fide word of correction and and they're pure hearted and they're humble grab somebody with you if it's a gal grab a gal you know if it's a guy bring another brother hey come over i think i got a word um man you're you know you're you're starting to take a class to pursue the call of god in your life and you're living with someone and you're not married um no let's make a choice right now and uh and so bring somebody with you so that that person can say no no no i was right there that's not what what was said there's a reason why pastor wane drain writes down all of his words on a yellow piece of paper pastor you once gave me a word show me the yellow piece of paper let's read it together so anybody else okay yes yes i'm sorry that's a great question great question the question was what do you do when you've got um prophetic people that are trying to direct the vision of the church it's the question is being asked from a senior pastor um standpoint um i would say um there already is a vision and i need you to get it and and to run with it um and if you're really convinced that god is giving you a vision maybe you need to pray about whether you should be pastoring a church um because two roosters in the hen house two visions in a church is division and so sometimes um there are people that that they don't have the guts to step out and do what god's leading them to do and they're trying to almost almost half heartedly um fulfill what god's been speaking to them about through you and they'll get frustrated well i think the church should be doing this or that i remember telling one seasoned prophetic voice who was so critical of the church that he didn't even attend one and i had to tell him i can't have you speak at my church if if you don't see enough value in the body of christ for you and your family to be attending one well john i haven't found a church that you know we like yet and i said well if you think everybody's doing it wrong maybe you need to start one why don't you show us all how to do it right you know so um i think sometimes it's uh i'm not denying that that there might be some things god's showing you i'm just telling you this is the vision of our house and this is who we are i've had so many people come up and say don't you think we should have this ministry that i had a gal come up to me one time and say don't you think we should have a hospice ministry and i said i i think hospice ministry is amazing that is not in my heart i said is it in your heart why are you trying to get me to run with the vision that god gave you now you're going to wear me out i got one and i'm doing all i can to fulfill what god's giving me so yeah i'll take a few more it's like five after and so yeah yeah yeah great question um question is you know that somebody before they knew the lord would get these premonitions or they'd they'd see people dying and and it would come to pass if there's a true there's gotta be a false bible's full of false prophets and so i think i think this um let me answer it in kind of a kind of different way um michael jackson was anointed he was a commanding presence on the stage oh my submitted to the holy spirit what could have happened um what could have so yeah i think that there are uh psychics i i the difference would be the source that you're getting your info from and so i don't i don't believe in ghosts you know i don't believe that you know um uncle edgar who passed away 20 years ago just walked through the room and looked at you and just kept walking i believe in familiar spirits i believe in a good god and a bad devil i believe in angels and demons i don't believe that there's a whole bunch of gray out there and you know they're good witches and bad witches i i believe that it's a lot more clear cut than that and so what's the source i had one gal tell me she ran a new age store where i lived and she would have psychics in um all the time and she said all of my psychics attend churches and i'm thinking i want to see a list of your psychics i want to know if they're in my tree and uh and so here's what a here's what a psychic will will say they'll say their gift is from god but they won't say that their information is from god who's your source who's your source um holy spirit is showing me right now who's your source so yeah did i is that a decent enough okay okay yeah tough tough tough i'll take one more and we're almost ten after yes sir wow look at the time i i i got a the question was how to how does the local church handle national um oh i get them all the time people send me videos all the time pastor if you have an hour can you watch this why would you believe i don't have an hour um so um i uh i don't want to follow a guy i don't want to follow a gal i don't care how well they're used um and a lot of people got their feelings hurt and a lot of people lost credibility because they went on record saying this that or or another thing um you put anybody on a pedestal it is not going to be long um and we need to look no further than some of the recent stuff that's come out i i and i hurt i hurt when we put anybody on a on a pedestal um i i i my heart aches um for all the people that have just gotten crushed um recently and so i god's called me to to ione michigan and the bible says in jeremiah 29 pray for the peace of the the the city or the place that i've called you to for its in in its peace you'll find peace or in its prosperity you'll find prosperity this is where god has called me if god's given you a national ministry you know good for you um i i don't know if necessarily that's and i don't know if we're going to be trying to steer the direction of our church based on what prophet or prophet is so and so just said on youtube um and so and how nice you don't have to be accountable you know to those people you know joel ostin isn't your pastor you know and and uh and there are some you know wonderful prophetically gifted people out there um but don't come to me as a pastor and say i just heard this word and i think we need to do this and don't try to force feed me you know some video what you want to do is you want to pray for me so that i would hear god so that i would have a direction um so i don't know is that okay all right all right all right okay guys well let me pray for you father um thank you for these amazing folks god i i pray now that you know you you you filled our spirits now fill our bellies father bless us the rest of this day and father i just pray that we go back ignited father to to speak your word to declare your word to be your voice to our generation and father i'm reminded of acts 13 that it says after david had done the will of god and his generation that he went home to be with the lord and so father here we are to do the will of you oh god and our generation and jesus name we pray amen god bless you guys thanks for coming


So, good morning, good afternoon or good evening, depending of where you are joining us today. We have the pleasure of having Professor Lance Price from George Washington University today as a speaker in the Knowledge Dissemination Dialogue of this month at FAO. This is a webinar organized by the FAO AMR Working Group and the FAO Sustainable Livestock Technical Network, always happening on the third Thursday of the month, around lunchtime here in Central Europe. A topic that Professor Lance will speak about is using source-associated mobile genetic elements to identify zoonotic extra-intestinal E. coli infections. And I'm sure by the end of the presentation, this will be more digestible than the title sounds like. Just a couple of housekeeping rules, please keep your microphone on mute. Please rename yourself with your organization and country followed by your name. Please note that Professor Lance's views are his own and not FAO's one. Please refrain from advertising your services, your company or any other commercial product or brand. And please post your questions in the chat, the box that you have in the Zoom. And the goal of this, it's called dialogue precisely because of that. We would like to have a lot of dialogue at the end and explore possibilities of collaborations between the speaker and the participants in this webinar. The meeting is being recorded, so please keep that in mind. And after it, we'll share the presentation and a couple of additional resources that Professor Lance shared with us. And at the end, we'll post a link for a feedback survey. So I'll stop here, Lance. And the floor is yours. Enjoy the webinar. Thank you for opening that up, Jordan. Hello, everybody. Good morning, good evening, good night. Let me open my slides. So you heard the official title. Here's my alternative title. Mama always said you could tell a lot about an E. coli isolate by its shoes. Where it's been and where it's going. And so the idea here is that by looking at accessory elements, particularly mobile genetic elements, we can start to predict what host an E. coli came from, regardless of where we isolated it. And so this is the official title. So, you know, I think it's important to just sort of start off with this fact that E. coli is a very versatile organism.  And so I think think about some of the major food animal species, at least in the United States, these are the dominant food animal species. E. coli colonizes all of them. It also colonizes our our interesting clip art person here. So it also colonizes us, right? So most most humans have some level of E. coli in their gut. And that E. coli is dynamic. And so, you know, from a from a molecular perspective, there are, you know, thousands of E. coli strains out there. You know, if you just look at the MLST database, you'll see, you know, literally thousands of different MLST sequence types. But from a clinical perspective, E. coli can really be bend, excuse me, into three different categories, you know, kind of the good or commensal, you know, benign E. coli that we all are probably carrying now. There's the dirogenic E. coli. Those kind of cause diarrhea, you know, like 0157H7 associated with feedlot cattle.  And those have lots of different monikers from UPEC urinary tract, you know, infecting E. coli to neonatal meningitis E. coli. But they all fall under this umbrella of extra intestinal pathogenic E. coli. So extra intestine. So it causes disease outside of the intestine. It's actually they're typically benign in the intestine. So they behave like a commensal otherwise. But when they get introduced into the urinary tract, they can cause infections. They get introduced into the blood, they can cause infections.   And and and the dominant organism when it comes to AMR deaths around the world. And so they have special virulence factors they can they can adhere to, you know, the the cells of the urethra and even under sheer force. Actually, they lock down even tighter under sheer force. They can cause bladder infections, kidney infections and sepsis due to or sorry, deaths due to sepsis. So in the United States, we estimate 36,000 to 40,000 deaths due to sepsis. So I just want to make sure that. Oh, sorry, I saw the I saw the chat came up. And I just want to make sure that wasn't for me. OK, I'm going to ignore it otherwise. So in, you know, we see that they're extensively resistant, E. coli strains becoming common around the world. The problem with this, you know, this extensive resistance is that if you can't stop an infection at the bladder, then it can it can ascend the ureters and get into the kidneys. And once it's in the kidneys, it has access to the blood. Right. And so, you know, when you present with a bladder infection, there's an opportunity. When you present with a kidney infection, there's an opportunity.  And the more resistant and E. coli strain is the more dangerous the situation is. So I want to lock this relationship together just for those of you who don't realize. I mean, I learned late in my career that UTIs, most UTIs are caused by E. coli. So, you know, 80 percent plus of urinary tract infections are caused by E. coli. They can live in our guts without symptoms, as I mentioned before. And we get these urinary tract infections, abbreviated as UTIs here, when these strains make this short trip from the anus to the urethra. Now, women are a much greater risk for UTIs because of the anatomy makes that trip easier. But we've been asking this question, not how do people get UTIs? I think that that's pretty well established. But how do we get the UTI causing E. coli into our guts? Because, again, it's not all strains that can do this. And so we know that people can pass them, you know, pass strains from person to person. And this is almost certainly the dominant pathway, right? Is that we, you know, the world's covered in a thin layer of poo. And we're sharing E. coli strains all the time. And the people that we live with are the people that were most at risk for picking those up.  But we've also been asking this question, you know, can people pick these up from food animals? And this does not, this question does not originate with me. I mean, this question started with studies from the 1960s in the UK, where they had outbreaks of urinary tract infections in hospitals that were traced back to the suspected poultry products in the kitchen. And then people like Jim Johnson, Amy Mangus, Lee Riley, and others around the world have been studying this, the potential transmission. And really what we're looking at is, you know, not so much direct transmission from the animals, but probably via meat. Because when we look in grocery stores and we look at meat, it's, they're almost always contaminated, or sorry, I should say very frequently contaminated with E. coli. So several years ago, now we started a study in Flagstaff, Arizona, the small geographically isolated city near the Grand Canyon. There was no food animal production there. And we decided we would go to every grocery store in the city twice per month by every brand of chicken, turkey, and pork. We didn't buy beef because beef was not suspected as a source at the time. And we bought every brand, brought it back, cultured it for E. coli. And then we partnered with the only hospital in the town and got every E. coli from every urinary tract infection and blood infection there. And so by the end of the year, we'd cultured nearly 2000 E. coli from meat and nearly 1200 from UTIs and blood. Now, we also have, we have another study that we're just completing in California with nearly 7,000 isolates. So maybe next time I can present on that. So the big question here is, what's the population overlap between the E. coli in the retail meat supply and the E. coli causing infections in people? And this was sort of my first experience, not my first experience with naivety, but the first for this study. My big sort of naive thought was that I could just draw evolutionary trees like we'd done when we were investigating the Haitian cholera outbreak or when we were trying to understand the evolutionary history of SC-398 or other outbreak situations. I thought we could just use those models. And so our plan was to use a three-step approach, which was to sequence the genomes, perform MLSD. So we basically just extract an MLSD sequence type from the whole genome sequences. And then for every sequence type where there was both meat and human isolates, we would do a whole genome single nucleotide polymorphism based phylogeny. So in other words, a core genome phylogeny on each sequence type. So we can really understand those fine level relationships. So here's what the sequence types look like. So we found 456 different sequence types among the samples. Some more prevalent than others. And so the size of the bubble here, each number here represents the sequence type and the size of the bubble represents how many isolates had that sequence type. And if we isolated an isolate from meat, it's in red. And if it was from a human urine sample or blood, it's in this nice urine yellow here.  But so you have ST131, no big surprises, the most prevalent among humans. ST117 should not be a huge surprise either. This is a prevalent one, at least in the United States today in poultry production. And so we decided, all right, this is very interesting because none of them are very few, are pure gold or pure red. There's always this overlap. And so we started drawing trees. And we started with ST131 because it was so important. And most studies had suggested there was no food involvement. And in our own evolutionary studies suggested there was no food involvement. But I was intrigued by this big group of meat-associated isolates. So we performed a core genome phylogeny. This is an unrooted tree. Again, the same colors pulled up. So human isolates are in gold and meat isolates in red. And you see that the tree has these different clusters. So this cluster up here, H30, is the pandemic strain of ST131 that's killing a lot of people today. It's nearly, it's extensively resistant, fluoroquine, cephalosporin, etc. But you see all the meats are falling here in H22. Another FIM H, so this has to do with fimbri. But you also see human isolates clustering and some clustering very closely. So what we did was we just used the genomes from the H22s and we did a higher resolution tree. And this one, this time this is a rooted tree. And what we see is that we see some clusters, some clades where we have very closely related human and meat isolates, human and meat isolates. So we thought we had it here and we said, all right, this is clear evidence that there's transmission from poultry to people. But when we submitted the paper, the reviewers pointed out that, you know, hey, you didn't show us the direction and you don't really have a transmission and you don't really have clonal relationships here. These, there's a lot of variability here. And in fact, there's very few clonal relationships in this tree. And this really underscored the diversity of E. coli and one of our big struggles with this. And so we went back to the drawing board here and, you know, we started thinking about this diversity and the fact that we're using these tools that are really for outbreak investigations.  I'd want a lot of samples, right? But then if you scale it to, and I'm sorry for the US focus, but that's where I do my research. And so we'll just use the US as an example here. Most of our poultry production is in what we call the broiler belt, the southeastern United States, some in California, some up the West Coast, but mostly here. And each dot here represents a million broiler chickens. And so we produce 9 billion broiler chickens across the United States, mostly in here. And, you know, so now think about that one farm and you've got them scattered across here and how many samples would you want now? I think it's practically impossible to sample enough to really define the E. coli populations. And so, and we're using these tools are really best suited for outbreak investigations. You know, we're making trees and we're counting SNPs. That works when you have a young clone disseminating from a single point source, which is usually the case for an outbreak, right? So that's exactly what this slide says. So here's a visual for that. So you have a farm that has a new strain of salmonella, for instance, multi-drug resistant salmonella emanating from a single farm. Well, that's getting, you know, that's contaminating poultry products and then getting packaged up and disseminated across the country. But that will, you know, you can trace that back with, you know, product codes and looking at epidemic curves. You can potentially trace this back. Now, the industry's made it very hard to do that in the United States, but it is possible to at least trace it to a slaughterhouse. But the E. coli populations that are causing urinary tract infections, this XPEC, are old, diverse and diversified. That is that, you know, even around a single clone, like an SD, sorry, a single lineage, there's a lot of diversity, a lot of SNPs there. And so what you have instead of this, you know, single point source is that you have this constant bleeding over from the food supply into the human communities. And, you know, clearly I'm not drawing all the arrows here. This would be a very, very red map what would make a lot of Democrats nervous in the United States. So, but what I realized is that we really don't need to pinpoint a specific farm. What we're trying to ask, the question is not to, at least at this stage, we're not trying to say, hey, which farm are these coming from? Because we know it's, we suspect that it's bleeding across the entire industry. We just want to know, hey, which ones are coming from chickens or pigs or cattle and which ones are coming from people? And so that's a different, very different question and takes a different molecular approach. And so, you know, I'm a pretty simple guy and I thought, well, wouldn't it be great if E. coli just wore uniforms so we could tell where they've been, right? So when you see a person that works in a hospital in their hospital scrubs or their white coat, hopefully they're not wearing that in the grocery store. But when you see them wearing those in the grocery store, you know where they work. And I would love something like that for E. coli. And so this is my second force gump reference here. You know, so one of the scenes in the movie, I don't know if we're familiar with this movie, but it was kind of a culturally iconic film in the United States. He's sitting on the park bench and he sees this woman and he points at her shoes and he says, you know, those look like comfortable shoes. And then he says, mama, my mom says that you can always, you can tell a lot about a person by their shoes, where they've been, where they're going. And I can tell just by looking at this person that she's a nurse. She works in a hospital.  I mean, this is a nurse. And this is what we need for E. coli. And so I talked to my colleague, Tim Johnson, Timothy Johnson at University of Minnesota. And he's been studying these avian adaptive Col. V. plasmids for years. And he said, hey, have you screened your collection for these? And so we screened them. And sure enough, you know, 64, 63% of the poultry isolates had these Col. V. plasmids and only 5% of humans. And so from my perspective, you know, these really look like the shoes that E. coli wears when they're hanging out with chickens, right? And so this was our first hint at using mobile host associated mobile genetic elements as potential source trackers. And the cool thing about these is that they're unstable when you take them out of the avian host, right? So here is this L.B. broth. This is E. coli with Col. V. plasmids grown in L.B. broth. Those plasmids are stable. That's easy living for E. coli and L.B. broth. And here's chicken litter. So they're grown in chicken litter. That's really stable. Here's the chicken cecum. The plasmids are super stable. And this is a graph from Tim Johnson at University of Minnesota. This is what happens when he introduced the E. coli to the mouse gut. They drop that plasmid very quickly. And so this is, I think, pretty cool because over time, as they switch hosts, they're going to shed these plasmids and they'll probably take on new ones. And so we could use these to recognize recent spillover. And so the idea here is that we have a person currently smiling, but she gets a urinary tract infection so we can collect a urine sample and then culture E. coli. And if we see these Col. V. plasmids, that's a pretty good hint that maybe that E. coli came from chickens. And so we went back to our ST131 study and we decorated the tree with these plasmids, the Col. V. plasmids. And sure enough, what we found was that almost all of the poultry isolates carry these plasmids as did the human isolates that were most closely related. And so for us, this was pretty strong evidence that these people were picking up E. coli from poultry. Now, they didn't pick it up from this chicken, but they picked it up from chicken, the chicken population. And the reviewers were commenced. So we hypothesized that E. coli populations adapt to these different vertebrate hosts by shedding and acquiring different hosts associated mobile genetic elements. And Col. V. is clearly not the only host associated mobile genetic element. E. coli has a massive accessory genome. And so there's a lot of data to mine there. And so we started mining the data. And so we think that there's a lot of different shoes that they're wearing. And so by doing a large scale comparative genomics, we've identified 17 hosts associated mobile genetic elements in E. coli. And I'll just say that I don't think that we exhausted the full accessory genome here. And so we're continuing to mine. But we found 11 associated with one or more food animal species. And then we found six associated with humans. Now, all of our isolates were invasive isolates, or sorry, they were associated with symptomatic disease. And so we may be picking up here, you know, plasmids associated with virulence, but they were very strongly correlated. And so here's our heat map. Here are the strength of the association between these elements, H1 through 6, the human associated elements, with the human isolates versus meat isolates. And here are the meat associated mobile genetic elements association with humans versus meat. And you see obviously this inverse pattern. And what I'll tell you right here is that there's a lot of co-linearity among the different meat isolates. So chicken, turkey, and pork. And so we only use this in a dichotomous fashion, so meat versus humans. We're currently working on, by increasing our pool of genomes, by, as I mentioned, I think another 7,000 genomes, we're hoping that we're going to be able to break this down and be very specific about the different hosts in the future. So here's the next time I was very naive with this study. I thought we could just combine all of these assays together and that we would go to 100% specificity, sorry, sensitivity. But what I quickly realized is that as we combine these, we were really, we increased to over 90% sensitivity for detecting humans. These are the human assays, but our specificity started decreasing. So the more we used, the less specific they were. And it really got bad when we were looking at the meat isolates. So our specificity really plummeted down to between 30% and 40%. And so we needed a different model than to just combine these in a straight fashion. And so that's when I talked to my mathematician friends here, Dan Park, Jenga Wu, and through a medium, we spoke to Thomas Bayes, so the father of Bayesian statistics. And this was really the brainchild of Dan and Jenga using this Bayesian latent class model. And so I want to explain this approach using sort of a cartoon version here. So with the Bayesian approach, you have a person with a UTI, we get the culture, and we get an E. coli. Now we want to know did this come from a human or did it come from food animals or meat? And so initially we just have a probability, that E. coli, so it will come from a human or a food animal. But we do MLST and we get a specific sequence type. That might shift the probability. So now we have a different posterior probability that E. coli came from a particular host. And then we can start looking at our host elements. And as we run through there, that posterior probability will change. And you can start to estimate a probability that an E. coli came from a particular host. And so this is kind of a dumb explanation for how the model works, but this is the way I think of Bayesian latent class model working. The great part about this is that by training the model, then we could go back and run our entire data set and we could get a probability that an isolate came from a person or from meat. And this is really super straightforward. And so what we did was we said, all right, we had to go with 80% or better, and then we would call it from a particular source. And so that's what we did. And here are our urine isolates and the probability of a meat origin. So here we have our human isolates. Most of them have nearly 80%, have a 0% probability of coming from meat, but we have 8.4% of them that have an 80% or better probability of coming from meat based on the model. Now, this could be a sloppy model. So we looked at the meat isolates and we asked the same thing. And what you see is that almost none, 5% of the meat isolates had an 80% better probability of coming from humans. So this suggested, A, we handed all our samples well, that was a relief, and the model is pretty tight, that the model appears to be doing what it's supposed to. And we also obviously ran some formal testing. So we deemed these foodborne zoonotic E. coli and we estimate, again, about 8% of human UTIs in the United States, where we have very high quality water sanitation, hygiene, and food animals are produced far away from humans. We have about 8% overlap. Now, that might sound like a small number, but that exceeds any of the other major Europathogenic species like Enterococcus or Klebsiella. And when you translate that to a national level, we're talking about 480,000 to 640,000 urinary tract infections per year that may be foodborne zoonotic E. coli. It turns out that FSEC isolates are similar to non-FSEC isolates. So extra intestinal pathogenic E. coli that appears to come from people, they have similar, they're similar in terms of virulence. So here's the virulence data, the only place where they were a little bit different, sorry, they're the same when it comes to, not statistically different when it comes to cystitis, the place where they were different was, they were less likely to cause pylonephritis, but they were not different in terms of ability to cause sepsis. A few strains appeared to have an enhanced zoonotic potential. So here we have, we've plotted the prevalence of a specific sequence type among the meat isolates. So this sort of is a gauge of stochastic potential for an E. coli strain to sort of bleed over into the food supply. So the higher up it is, the more likely a human is going to come in contact with it by handling meat. And then the x-axis here represents the percent of clinical cases that, of a particular sequence type. So the further right on this axis, the more potentially virulent they are. Now this is, this is all cases, including asymptomatic bacteria. So that's just bacteria in the bladder. Here is symptomatic cases. So this is confirmed cystitis and pylonephritis and sepsis. And what you see is that a couple of sequence types really jump out, ST131, ST58, 10 and 69 are further right on this chart. ST117 is still right about 5%. And so it may be a little less benign but has a lot of stochastic potential. And then here are our sepsis isolates. And really ST58 jumped out. But this is a very small number of sepsis isolates. And so this is one case versus two. I'm not putting a lot of weight on this yet. We're doing some additional sepsis studies now. So when I think about this, and I talk about these high risk strains, and I talk about my, to my colleagues, like Tim Johnson at University of Minnesota, I find that some of these strains also cause disease in livestock, particularly poultry actually. And so by developing vaccines against these strains and applying them to the food animals, I think we could really have a win-win for public health and food animal production where we could decrease disease in the animals and then also decrease the bleeding over of these strains to people. And I'm really, I love win-wins. I often find myself, you know, angering the food animal industry in the United States by, you know, whining about antibiotic use and disease. But I think that this is one place where we could really team up. And when it comes to antibiotic resistance, you know, these strains were not, you know, they were fairly reflective of what we saw in the, among the meat isolates. But they were distinct from both meat and humans. And so these are our FSEC, so these are human clinical isolates that appear to be of zoonotic origin. You know, they were resistant to some important drugs, you know, and, but significantly less resistant than the human clinical isolates. And I really, you know, mark this up to the FDA's limiting of some of the most important antibiotics in food animal production in the United States over the past two decades. So we're, we still stand out among high-income countries in terms of quantity of antibiotics that we use, but we are mostly using tetracycline. And I say we, I'm not using any in animals, but the industry uses a lot still, but mostly tetracycline. And so I think that's prevented us from having the worst resistance patterns here. So these FSEC appear to be unique from both food-ass animal isolates and non-FSEC isolates in terms of resistance. But I think it's really important to point out, especially with this international group, that these strains could vary widely with geographic location because of differences in antimicrobial use. You know, it's a big planet and particularly the BRICS nations, Brazil, Russia, India, China, South Africa, we've seen this rapid, we're seeing this rapid development and this rapid sort of shift to meat-centric diets. And so we're seeing a lot of industrial, you know, industrialization of poultry production, pork production in some countries. And so this could be a problem. And we've seen, hopefully you've seen this Tom Van Boko study about antimicrobial, a previous study about antimicrobial use and this one about resistance rates. And what we see is the steady increase. And so, you know, I think we have to keep this in mind. And so likewise, I think the prevalence, just specifically the prevalence of FSEC infections could vary widely because of differences in environmental controls like water, sanitation and hygiene, but also the proximity of animal production to human communities and the level of subsistence farming. And so we have a paper that's under press right now about antimicrobial use and food animal production in Cambodia. You know, in Cambodia, you have over-the-counter use of antimicrobials in humans. You have over-the-counter use of antimicrobials in industrialized animal production. You even have antimicrobial use in subsistence farming. You have untreated human waste going into surface waters. You have animal waste going into surface waters. You have food being produced in those surface waters. You have open defecation. You have, you know, fish farms. And then you have some rudimentary slaughtering procedures. And so I think the ability for sort of bi-directional exchange is really underscored in an environment like this. And so I just want to wrap up with my last couple of slides so that we can have a lot of time to talk. And so, you know, our current efforts right now are to expand our host-associated element panel. And so we have, again, another seven or 8,000 E. coli genomes that we're analyzing, actually more than that because we've scraped the databases. We're looking to, again, get very specific with the host predictions. I don't know that we'll ever be able to split, you know, chicken from turkey. And globally, I don't know that that matters because turkey's kind of, you know, very regionally produced. It's popular here, especially at Thanksgiving. We want to improve host... That's what I just said, improve host predictions. We would love to develop an online tool with, you know, pathogen watch and other groups so that people can upload a genome from anywhere in the world and then get a prediction. We're also, and this is an important one, and I'm really putting a call out to you and to your colleagues, we would love to expand our isolic collections from humans and from, particularly from the dominant food animal species and low and middle income countries so that we can look at geographic variation and host elements and develop a geographically informed Bayesian latent class model that would allow people, again, to upload a genome or, you know, send an isolate for sequencing, upload that genome, say what geographic region they're from, and then get a prediction of source. And so if you have isolate contemporary isolic collections or you'd like to partner, please email me at lpricet at gw.edu. This is not a product. This is collaboration, George. Anyway, so that's the last of my official slides. Here's this, the requested slide here. And then I just want to acknowledge all my wonderful colleagues before I open up to questions. So my colleagues at George Washington University, Malia Aziz are bioinformaticist, Dan Park is an amazing statistician, epidemiologist, Northern Arizona University, particularly Paul Keim, University of Minnesota, Jim Johnson. Tim Johnson, Jim came up with the term XPEC. Staten Cerem Institute in Denmark, Mark Stegger, University of Michigan. So Jenka Wu and Mingbing Li, his doctoral student, were really pivotal in developing these Bayesian latent class models. And then, of course, my funders and my old colleagues at TGen. And with that, I'll stop my sharing and open it up to discussion. Thank you very much, Lance. And I knew it to be good. I didn't expect it to be this good. So it's brilliant that we aim to have these webinars on data-rich presentations, and yours could not be more data-rich. And yeah, regarding source attribution, and I think some of these data will be a lot of useful for risk managers later down the road. And what you mentioned, the connections with the different use volumes and the different antimicrobial use policies is something that is super interesting to further analyze. And you did it very well. The goal of these webinars is to trigger collaborations to find... We are all aware of the dimension of AMR, and we want this forum, this platform, to be used to find solutions, not just reinforce the problem. So yeah, like you said, it will be much appreciated if this will trigger sharing isolates with you from low and medium-income countries. And I see that you have a lot of participants from several different countries and regions. So yeah, I think you did it. Thank you for inviting them to collaborate with you. Thank you. Yeah, and we have some funds that we could pay for sequencing and shipping. And so I would really love to work with people. Brilliant. We got a question. It's an interesting one because you mentioned a lot about chicken and poultry. So you got a question regarding do vegetarians and vegans get less urinary tract infections? And how would this relate to your work? Yeah, so Amy Mangus is, I think, just a really brilliant epidemiologist. She left the field about 10 years ago, but prior to leaving, she'd done some studies looking at poultry consumption, poultry handling, and risk for UTIs. And there was a dose-response relationship. So the more exposure you had to poultry, the less, the more likely you were to get a urinary tract infection. And we know that the X-PEC are sort of predominate in poultry products. And so I think that that's pretty good evidence. I haven't seen great studies on vegetarianism yet. I think one of my concerns there is that I think it clearly could reduce your risk. If you're not handling these products in your kitchen, there's less risk for cross-contamination now, I would assume. But the problem is that the fecal waste from those animals is used as fertilizer. And so I think that you do have this environmental dissemination. And then if you're a vegetarian that also dines in kitchens where they handle meat, then there can be cross-contamination there as well. But yeah, I would suspect that it would reduce your risk. Great. Thank you, Lance. Next question, besides complimenting you, how do you think the host-level resolution of mobile genetic elements will work out, especially once low and middle income data is available, taking into account the leakiness between hosts and environment in the bi-directional, multidirectional transmission? Hey, I love that somebody used the term leaky. That's great. Leakiness. Yeah, we've tried to introduce this term. So that's brilliant. So with Maya and Adam Polly, who's now at Emory. So I think that that's going to be a challenge for us, is that as we go into low and middle income countries, I think the system becomes noisier. And what I'll just, this is between us in this room, we've been analyzing publicly available data. And what we see is that it appears that people living in low and middle income countries might have twice the risk of the high-end people living in high-income countries for invasive infection by these foodborne zoonotic strains. And so I do think that leakiness is going to play a role. Now the question is, how do we identify in a robust way mobile genetic, host associated mobile genetic elements in these leaky systems? Because the more they bleed together, and I think that's the point of the question, the more they bleed together, the less clear the signal is going to be. And so I think we've got to hold our judgment until we get in there and start to assess this. But we may have to develop our models as best we can in the higher income countries, in the cleaner setting, just sorry, less leaky setting, and then apply them in these settings so that we have that clear signal. We know what we're talking about in terms of host associated elements. And then, but it could be that there are industrialized animal production systems that are well enough isolated in some of these places where we start to get that. But again, it's an open question that we're very eager to explore. There you are. So maybe you've just started a new collaboration with Dan Sharpe, the colleague that's asking the question. The next one, what about the role of the environment? The colleague has done some limited work at surface waters and many of the nasty E. coli they found were expects and UTI associated sequence types. Could these faulty strains be environmental strains that are being shared between environment humans and animals? The one health perspective of this issue. Yeah, certainly. And I think that there have been some studies out of Japan looking at wild animals that are picking up some of the really important expect strains. Yeah, I mean, I think that there can be this movement of the strains from human populations into the environment through contaminated surface waters. There can be from the food animal populations themselves. Think about migratory birds. I think about what's called the Delmarva Peninsula here across the Chesapeake Bay from where I live. There's half a billion chickens that are raised out there.  And so I think the ability for these wild animals to pick up these strains and then carry them around is also big. And then the wild animals themselves might have their own avian pathogenic strains that can be shared with people. And so it's a world full of poo, right? But I think what's happening when you compare those sort of natural populations to what's happening in industrialized food animal production though, it's a very different risk formula because of the rampant use of antimicrobials. And so I think that that really elevates the risk because we talk about antibiotics being the foundation of modern medicine. But in some low and middle income countries, they're not the foundation of modern medicine. They are modern medicine. And if that antibiotic that somebody got out of clinic for a dollar or whatever, if that doesn't work, they could die because they can't afford anything else. And so I think that we really have to value these. And unfortunately this model, and I really want to own this for the Americans, right? We developed this industrialized model using antibiotics and we've exported it to the world as this sort of super efficient way to raise animals. Meanwhile, over the past 20 years, the FDA has started to ratchet back the antibiotics that can be used in a very sort of slow and frustrating way for me. But they have ratcheted back in a nuanced way. But that nuance, I think, has been lost for a lot of countries around the world. And so you're seeing sort of no holds barred use of antibiotics and animals. And I think that that's a huge threat. And then some of these, sorry, there's a long answer, but some of these countries, one of the ways that they're generating income is by mass producing animals and then exporting products. And so they can be exporting very contaminated, potentially dangerous products. Okay, thank you, Lance. The next one, again, more compliments, well-deserved compliments to your presentation. The colleagues have been recently looking at the potential transmission of E. coli from healthcare settings and community settings. There was high resistance for both, I believe, antibiotics resistance. However, they did not see much whole strain relationship but rather mobile genetic elements. Could this mean independent clonal transmission or how would these mobile genetic elements be moving around outside the whole strains? Yeah, so I want to make sure that we're clear when we're talking about mobile genetic elements. So I've got these host-associated mobile genetic elements that are not necessarily associated with antimicrobial resistance that I'm using to sort of identify host. But then we've got these mobile resistance elements, the R-plasmids, for instance, the resistance elements that are moving as well. And so I've been in my career, I've been mostly interested in the clonal transmission or the transmission of strains from food animals to people and really trying to quantify that. The other really important aspect is the movement of resistance elements. So you have the evolution of these new combinations of resistance elements in animals or in people that can then be transferred from one group of hosts to another, depending on wash conditions and other conditions. And I think the most striking example, kind of contrasting example that I've seen of this, and this is in the Maya non-empolis paper that we've, it's on bio-archives right now, but it's this leakiness paper that we wrote up, is that you see, if you compare the United Kingdom and the exchange of ESBL genes between food animals and people, there's very little overlap, right? So one of the wealthiest countries in the world, very high-quality water sanitation hygiene, separation of animals and people. Then you compare that to what we're seeing in Cambodia and there's tons of overlap with the ESBL genes. And the most striking thing that I saw there was that we saw this, we looked at the evolutionary tree of E. coli there. So we just looked at all the E. coli strains, we drew a tree, and then we looked at this one transposon that had the Q and R gene, so fluoroquinoline resistance and ESBL resistance on this transposon, and it was scattered across the tree. This really suggests that these things are moving prolifically in that setting, and we've never seen that here. I hope that answered your question. I think so. One question about the importance of the proper identification of the species, and the colleague is asking, what about the misidentification of some strains like Isirisi Alberti? Is this possible? Can this be happening? It certainly can be happening, but not in our study because we did whole genome sequencing and we identified the species by the whole genome sequence. And so I think in our case, it's clean and I think, yeah, it really depends on how you're doing your species ID, but I think that that's important. I don't know the virulence potential of that particular species. I'm not familiar with that anyway. All right. The next one, colleagues that have been looked at commensin ecoli from animals with a majority with MPC, BLA-EC-15. What do you think is so special about this BLA-EC-15 and not another bectolectomases? So that's the C-T-X-M-15, right? Yeah. So I think the big thing about C-T-X-M-15 is that it found true romance in the ST-131 lineage, right? So that was this perfect marriage for damage to humans, right? So ST-131 is this amazing colonizer. It's really sticky. Oh, sorry. I had it wrong. BLA-EC-15. Oh, you know, I actually can't speak to BLA-EC-15. I'm sorry. I was not familiar with that. No, sorry. All right. Good. The next one is a good proposal on the possibility of making a microbial committee that you can share information from time to time. Those that are interested in following up on your research, how they be able to, is there already a formal mechanism to change information about this or? Could you repeat the question? So the availability to make a microbial committee so that you can be sharing information from time to time? Well, you know, I'm happy to share any time you want to invite me back. I'm, and I think I would really love to develop an international network of people, particularly working on bloodstream infections, but also that we could, we could look at food animal species in the low and middle income countries. So I don't know the best way to, to establish that, but maybe George, maybe this is something that, that we can continue to talk about. Because yeah, I mean, I can tell you that we actively try to translate our work. So whenever we publish something new, we try to put it out in pretty plain English so that people can digest it. But, and we have a whole series of papers coming out. I'm still, I'm still embarrassed that I don't know much about BLAA EC-15, but I'm going to learn about that. Well, I can follow up on the afterwards the webinar. And the last question that we'll take just for the sake of time. A colleague is asking, why do you think people in Cambodia are not showing more endemic resistance illness, even the conditions presented in your slide, meaning increased exposure? Wait, could you start from the top? Why do you think people in Cambodia are not showing more AMR illness, given the conditions presented in your slide, meaning increased exposure? Yeah, I mean, I don't know the incidence rates in Cambodia, what I know are the, you know, all I know are the E. coli samples that we collected there, that, sorry, that Maya collected there. I can't really take any credit for the collection, just analysis, but just the level of resistance that we're seeing there. Yeah, I don't know who is tracking incidence rates, you know, globally as anybody. I mean, it's really, glass is supposed to start doing this, right? Yeah, from the human side. I don't know that we really have a good, sort of, across the world comparison yet. All right. Thank you, Lance. I think we will stop it here for the questions, and, but thank you very much for your presentation. What a privilege to all of us to be able to click on the link and listen to these presentations. And I think throughout the presentation and now in the discussion, several follow-up possibilities came up and a very concrete one, like you said, the possibility of colleagues to send you some isolates. And then from there, maybe you can reach the microbial committee that was also suggested in the chat. So I'll stop it here. Let's just share the upcoming, you can share, yes. So the next one will be on June 18. And this time we'll be focusing on Asia and the resistance to last resort across One Health in Thailand and neighboring countries by a professor Rungthip from the university from Thailand. And we'll send you out the feedback questioner. And if you have any further suggestions or ideas for this work, you can email us via the Antimocular Resistance at FAO.org. So thank you very much. And thank you very much. Thank you very much. Bye-bye.