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Antibiotic Resistant Bacteria and How to Counter Them

Graphic image of a skeleton Antimicrobial resistance, or the ability of a microbe to resist the effects of medication previously used to treat them, is a growing threat to both public health and the warfighter. (Photo: Courtesy of the Defense Threat Reduction Agency)

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Armed Forces Health Surveillance Division | Pandemic Diseases

Doctors are increasingly concerned about the potential for a "post-antibiotic" era when the highly effective drugs that we have relied on for many years to cure some of the most common illnesses will become ineffective.

The problem stems from the misuse of antibiotics, which are common medications that aim to kill infectious bacteria or prevent them from reproducing, thus getting rid of infections and their symptoms.

As use of life-saving antibiotics has increased around the world, some bacteria are becoming resistant to this type of medication. Those antibiotic-resistant bacteria can evolve into so-called superbugs, which can spread and become more dangerous, according to the Centers for Disease Control and Prevention.

Misuse of antibiotics includes overuse and not following correct protocols, such as the failure to finish your whole treatment to completely kill off the bacteria; or taking antibiotics to treat symptoms of infection without knowing for sure whether it's a bacterial or viral infection. (Antibiotics don't work for viral infections, such as COVID-19, the flu, colds, pneumonia, or herpes.)

It's an especially acute concern for the military community and military readiness because service members who deploy around the globe can be exposed to many different types of bacteria.

For example, "during conflicts in the Middle East, military members were infected with a highly resistant bacterium, Acinetobacter baumannii," said Navy Capt. Guillermo Pimentel, chief of the Defense Health Agency's Armed Forces Health Surveillance Division (AFHSD).

"The complexity of these infections caused longer recovery times and often resulted in catastrophic disability," he said.

To avoid this and to protect and treat deployed forces, "it's crucial to determine the amount of antibiotic resistance in different geographic regions and track the movement of antibiotic resistance genes," he said.

And because wounded, ill, and injured service members have returned home at increased rates due to advances in first aid and casualty care, there is growing risk of "possible transmission into Veteran's Affairs and civilian medical care facilities as service members leave active duty," said Army Maj. Ashley Hydrick, lead of the Antimicrobial Resistance Focus Area for the Defense Department's Global Emerging Infections Surveillance (GEIS) Program at DHA. The program is housed within the AFHSD.

The AFHSD conducts medical surveillance to protect service members and U.S. allies. As part of its support for the National Action Plan for Combating Antibiotic-Resistant Bacteria, AFHSD's GEIS program partners perform surveillance to identify where antibiotic resistance (AR) infections are occurring, both within the Military Health System and in partner nations where service members are (or could be) deployed.

AR is one of the greatest contemporary threats to global public health, according to a 2019 CDC report. It can affect anyone at any stage of life and anywhere in the world, but those with chronic illness are at greater risk.

In the United States alone, 2.8 million people are infected with AR bacteria or fungi every year, and more than 35,000 people die due to AR-associated infections, according to the agency.

The World Health Organization has sounded the alarm about the potential risks around the world. "Without urgent action, we are heading for a post-antibiotic era, in which common infections and minor injuries can once again kill," the WHO warned in 2020.

How you can help

Infections caused by AR germs are difficult, and sometimes impossible, to treat. "In most cases, AR infections require extended hospital stays, additional follow-up doctor visits, and costly and toxic alternatives," according to the CDC.

And while it is difficult to completely avoid the risk of AR infections, individuals can help mitigate risks.

"Service members and the public can do their part by working with their health care providers to take any prescribed antibiotics as instructed, to always finish their prescribed course of antibiotics, and never take antibiotics without the instruction of a health care provider," said Hydrick. "We can also do the same for our animal companions.

Adopting healthy habits can help protect us from infections. Some of these include getting recommended vaccines, taking good care of chronic conditions, like diabetes, keeping hands and wounds clean, and talking to your health care provider or veterinarian about whether antibiotics are needed, says the CDC.

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