Medora Witwer, MPH, CIC: Stories of Antibiotic Use and Resistance

I work in tracking of bacteria resistant to carbapenems (broad spectrum antibiotics important for human health) at the Minnesota Department of Health. Two of the most important bacteria that I track are carbapenem-resistant Enterobacteriaceae (CRE) and carbapenem-resistant Acinetobacter baumannii.

Every day I see reports of antibiotic resistant bacteria and follow up with labs, infection control, or medical records. Part of my job is to figure out what’s going on with these bacteria in our state, to see if there are any strange trends that might show an outbreak, or highly resistant organisms that need to be prevented from spreading. In Minnesota, we’ve expanded our CRE surveillance to statewide, so I’m busier than ever!

Antibiotic use is one of the ways that resistance to antibiotics begins, including antibiotic overuse. I sometimes receive reports of organisms that are nearly pan-resistant, which means they’re resistant to almost every method of treatment. Without improvement and more efficient planning in our use of antibiotics, we risk losing one of our most important tools to treat infections.

All Minnesotans play a part in being responsible users of antibiotics. We as consumers need to understand when antibiotics work, the risks associated with unnecessary antibiotic use, and how to take antibiotics responsibly when prescribed.

I worry that our ability to practice medicine will be greatly altered by a lack of resources to combat resistant bacteria. It’s good to remember that everything is connected, and I worry about unforeseen consequences as much as I do about the known ones.

I would be very interested to learn more about how person-to-person transmission occurs, especially in a community setting. The more we know about how these bugs move and act and how people are infected and become carriers, the better we can work to prevent spread.