Jennifer L. Dale, PhD: Stories of Antibiotic Use and Resistance

I work within the microbiology unit of the MDH-PHL where we use several techniques to rapidly identify bacteria containing specific antimicrobial resistance genes. One of our main focuses is further characterization of bacteria resistant to carbapenem antibiotics. We employ testing methods to determine if bacterial isolates harbor carbapenemase genes, which make the organisms resistant to carbapenem antibiotics, and have the potential to spread among bacteria. The ultimate goal is to identify emerging resistance threats to prevent bacterial spread within health care settings and improve patient care.

There is a noticeable increase in antibiotic resistance since the COVID-19 pandemic, in part due to decreased surveillance for bacterial infections during the height of the pandemic. In general, there has been an influx of samples received at the MDH-PHL for carbapenemase testing and an increase in requests to perform outbreak investigations. These investigations involve testing individuals within certain health care settings to determine if they are colonized, or harbor antibiotic resistant bacteria that aren’t necessarily causing an infection, but have the potential to spread throughout a facility negatively affecting compromised individuals.

Getting people to understand that they need to take their entire course of prescribed antibiotics, even if they are feeling better halfway through their bottle of pills, to prevent any increases in antibiotic resistance.

I’m worried most about not having fast enough generation of new-line antibiotics to combat current antibiotic resistance, let alone any new resistant organisms identified in the future.

I’d like to understand the percentage of empiric antibiotic prescribing that occurs without definitive evidence of a bacterial infection to better understand if 1) empiric treatment is leading to increases in antibiotic resistance, or 2) if we can develop more rapid and accurate testing methods to improve empiric choices for treatment.