Antibiotics are important to the care of service members, especially those returning from the battlefield. But the rise in antibiotic-resistant bacteria concerns Military Health System (MHS) officials who are closely monitoring the rising trend and working to combat it.
“Improvised explosive devices (IEDs) result in a great deal of infections,” said Army Lt. Col. Kurt Schaecher, chief of the Infectious Disease laboratory at Walter Reed National Military Medical Center in Bethesda, Maryland. “The fragments from the IEDs are not clean – they’re covered in dirt and whatever bacteria and fungi in the dirt with the IEDs and the shrapnel comes off and goes into the wounds. Patients get very deep-seated infections often resistant to many antibiotics at the same time, making it hard to treat.”
“There are a lot of different efforts within the Department of Defense to develop different therapies for drug-resistant bacteria. We’re hoping this furthers the actions on this subject.”
That’s why Schaecher was recognized for his work identifying the first colistin-resistant mcr-1 positive E. coli in a person in the United States in May 2016. He received the Healthcare Excellence in Patient Safety award at the AMSUS (the Society of Federal Health Professionals) meeting, Dec. 1, 2016, at National Harbor near Washington, D.C. Colistin is an antibiotic of last resort, and the mcr-1 gene that causes the resistance can be transferred to other bacteria. If that happens, it would render colistin ineffective. Often, these bacteria are already resistant to many other antibiotics.
“Colistin is an antibiotic we pulled out often during Operation Iraqi Freedom, because there was so much multidrug-resistant bacterial infections that came out of the service members who were wounded, which resulted in loss of limb,” said Schaecher.
The double-edged sword of antibiotics is on the one hand they’re great at fighting infections; on the other hand, their overuse results in bacteria able to resist. The military’s concerns about this and a 2014 presidential executive order prompted the MHS to expand its efforts to stop the resistance. The Department of Defense enhanced surveillance for resistant bacteria, improved stewardship of new and existing antibiotics, and developed new diagnostic tests and treatments. All of this was done with international efforts in mind, given the worldwide footprint of the military.
Schaecher said the discovery of the gene is a good wake-up call to the state of antibiotic resistance in the U.S.
“Hopefully that wake-up call will push us to move forward with new, innovative therapies for bacterial infections,” said Schaecher. “There are a lot of different efforts within the Department of Defense to develop different therapies for drug-resistant bacteria. We’re hoping this furthers the actions on this subject.”