A 49-year-old Pennsylvania woman made history when she sought treatment for a urinary tract infection in May 2016. This year's observance of World Antibiotic Awareness Week (November 14-20) highlights the implication of her clinic visit and the subsequent discovery of her bacteria carrying a gene resistant to colistin, a "last resort" antibiotic. This was the first discovery of its type in the U.S., underscoring the importance of safeguarding antibiotics.
Antimicrobial resistance is defined as a microorganism's resistance to an antimicrobial drug that was once able to treat an infection by that microorganism. A person cannot become resistant to antibiotics. Resistance is a property of the microbe, not a person or other organism infected by a microbe. Superbug is a term often used by the media to describe bacteria that cannot be killed using multiple antibiotics. Resistant microbes are increasingly difficult to treat, requiring alternative medications or higher doses - which may be more costly or more toxic.
Although antibiotic-resistant bacteria have been around for years, the detection by the U.S. Army's Multidrug Resistant Organism Repository and Surveillance Network (MRSN) of this resistant gene called mcr-1 is important because of its resistance to colistin and its transferrable piece of DNA, called a plasmid, that can jump from one strain of bacteria to another. These types of resistant genes threaten the effectiveness of commonly used antibiotics for illnesses or injuries. Furthermore, "superbugs" could be created by the accumulation of these genes in one or several types of bacteria so that no antibiotic would be available to treat infections.
According to the Centers for Disease Control and Prevention (CDC), at least 2 million people in the U.S. become infected with antibiotic-resistant bacteria each year and at least 23,000 people die as a direct result of these infections. Efforts like World Antibiotic Awareness Week work to stop antibiotic-resistant bacteria through the promotion of more effective antibiotic use among patients and physicians.
Meanwhile, medical researchers at the MRSN, which is part of U.S. Army's Walter Reed Army Institute of Research (WRAIR), continue to detect, analyze and help physicians and hospitals eradicate drug-resistant bacteria before they spread. The MRSN investigates all samples of antibiotic-resistant bacteria collected from military medical facilities and includes a microbiology and molecular laboratory and an organism repository with some 45,000 isolates. By collecting and characterizing organisms, the MRSN helps inform best clinical practices and spearheads national infection prevention and control efforts.
"The MRSN has been assigned by the White House to lead the charge in antibiotic-resistant research and collaborate with other agencies to get ahead of this urgent public health issue," said Lt. Col. Kate Hinkle, MD, an infectious disease physician recently appointed as director of the MRSN.
Success in combating antibiotic-resistant bacteria will also depend on increasing awareness of this issue among the general public, Hinkle said.
"Misuse of antibiotics is the primary way resistant bacteria develop, so more awareness and education is needed among both the healthcare community and general population," said Hinkle. "The good news is that bacteria lose their resistance over time if antibiotics are used appropriately, which reinforces the importance of proper prescription use."
In recognition of World Antibiotic Awareness Week and as antimicrobial stewards, the MRSN offers these tips to healthcare providers and patients: