To Your Health With Dr. Jim Morrow: Episode 20, Infections and Antibiotic Resistance

In this edition of “To Your Health with Dr. Jim Morrow,” Dr. Morrow discusses infections, germ-resistant bacteria, antibiotic resistance, and how you should protect yourself and your family. “To Your Health” is brought to you by Morrow Family Medicine, which brings the CARE back to healthcare.

About Morrow Family Medicine and Dr. Jim Morrow

Morrow Family Medicine is an award-winning, state-of-the-art family practice with offices in Cumming and Milton, Georgia. The practice combines healthcare information technology with old-fashioned care to provide the type of care that many are in search of today. Two physicians, three physician assistants and two nurse practitioners are supported by a knowledgeable and friendly staff to make your visit to Morrow Family Medicine one that will remind you of the way healthcare should be. At Morrow Family Medicine, we like to say we are “bringing the care back to healthcare!” Morrow Family Medicine has been named the “Best of Forsyth” in Family Medicine in all five years of the award, is a three-time consecutive winner of the “Best of North Atlanta” by readers of Appen Media, and the 2019 winner of “Best of Life” in North Fulton County.

Dr. Jim Morrow, Morrow Family Medicine, and Host of “To Your Health With Dr. Jim Morrow”

Dr. Jim Morrow is the founder and CEO of Morrow Family Medicine. He has been a trailblazer and evangelist in the area of healthcare information technology, was named Physician IT Leader of the Year by HIMSS, a HIMSS Davies Award Winner, the Cumming-Forsyth Chamber of Commerce Steve Bloom Award Winner as Entrepreneur of the Year and he received a Phoenix Award as Community Leader of the Year from the Metro Atlanta Chamber of Commerce. He is married to Peggie Morrow and together they founded the Forsyth BYOT Benefit, a charity in Forsyth County to support students in need of technology and devices. They have two Goldendoodles, a gaggle of grandchildren and enjoy life on and around Lake Lanier.

Facebook: https://www.facebook.com/MorrowFamMed/

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Dr. Morrow’s Show Notes

Antibiotic Resistance

Antibiotic resistance is one of the most serious public health problems in the United States and threatens to return us to the time when simple infections were often fatal.
Antibiotic resistance is a national priority, and the U.S. government has taken ambitious steps to fight this threat.
- For example, it established a National Strategy and an accompanying National Action Plan.
Federal agencies are working together to:
- Respond to new and ongoing public health threats
- Strengthen detection of resistance
- Enhance efforts to slow the emergence and spread of resistance
- Improve antibiotic use and reporting
- Advance development of rapid diagnostics
- Enhance infection control measures
- Accelerate research on new antibiotics and antibiotic alternatives
CDC is working to improve antibiotic prescribing and use in human health care, and educate patients about the importance of appropriate use.
When we optimize how we use and prescribe these drugs, we protect patients from harm and combat antibiotic resistance.
Antibiotic resistance has the potential to affect people at any stage of life, as well as the healthcare, veterinary, and agriculture industries, making it one of the world’s most urgent public health problems.
Each year in the U.S., at least 2 million people are infected with antibiotic-resistant bacteria, and at least 23,000 people die as a result.
No one can completely avoid the risk of resistant infections, but some people are at greater risk than others (for example, people with chronic illnesses). If antibiotics lose their effectiveness, then we lose the ability to treat infections and control public health threats.
Many medical advances are dependent on the ability to fight infections using antibiotics, including joint replacements, organ transplants, cancer therapy, and treatment of chronic diseases like diabetes, asthma, and rheumatoid arthritis.

Brief History of Resistance and Antibiotics

Penicillin, the first commercialized antibiotic, was discovered in 1928 by Alexander Fleming.
- Ever since, there has been discovery and acknowledgement of resistance alongside the discovery of new antibiotics.
- In fact, germs will always look for ways to survive and resist new drugs.
- More and more, germs are sharing their resistance with one another, making it harder for us to keep up.

Germ Defense Strategies

To survive, germs are constantly finding new defense strategies, called “resistance mechanisms,” to avoid the effects of antibiotics.
- Bacteria develop resistance mechanisms by using instructions provided by their DNA.
- Often, resistance genes are found within plasmids, small pieces of DNA that carry genetic instructions from one germ to another.
- This means that some bacteria can share their DNA and make other germs become resistant.

What Can You Do?

Ask Questions and Speak Up
- Talk to your healthcare providers about questions or worries you have.
- For example, at a doctor’s office:
  - What can I do to prevent infections?
  - What do I need to know about the antibiotics you’re prescribing?
- At a healthcare facility, like a hospital or nursing home:
  - What do you do to prevent infections?
  - What test will be done to make sure I’m getting the right antibiotic?
  - What are you doing to prevent a drug-resistant or difficile(life-threatening diarrhea) infection?
  - Do I still need my medical device (for example, catheter)?
- Also ask your healthcare provider about cleaning their hands before touching you, such as:
  - “Would you mind cleaning your hands before you examine me?”
  - “I’m worried about germs. Will you please clean your hands once more before you start my treatment?”
- Clean Your Hands
  - Regular hand cleaning is one of the best ways to remove germs, avoid getting sick, and prevent spreading germs.
- Recognize Early Symptoms of Infection
  - Tell your doctor if you think you have an infection, or if your infection is not getting better or is getting worse. Some infections, like skin infections, appear as redness, pain, or drainage at an IV catheter site or surgery site. Symptoms of a difficileinfection include severe diarrhea, loss of appetite, abdominal pain/tenderness, and nausea. Often these symptoms come with a fever.
- Remember Pets Share Germs
  - Sometimes animals, including pets, carry germs that can make people sick.
  - Wash your hands thoroughly with soap and water after:
  - Touching animals or anywhere animals live
  - Handling pet food
  - Cleaning up after pets or livestock
- Sepsis is a medical emergency.
  - Sepsis is the body’s life-threatening response to an infection.
  - Visit Get Ahead of Sepsis for more information on how you can protect yourself.
- What is resistant—my body or the germ?
  - Antibiotic resistance does not mean our body is resistant to antibiotics; it means that the bacteria or fungus are resistant to the antibiotics designed to kill them.
- Get Vaccinated
  - Vaccination is one of the best ways to prevent illnesses.
  - Every year, thousands of Americans get sick from diseases that could be prevented by vaccines.
  - Talk to your child’s healthcare provider about recommended vaccines, and learn more about vaccines recommended for all ages.
- Prepare Food Safely
  - Bacteria in food can make you sick, and these infections can be caused by drug-resistant germs.
  - Learn about food safety and follow four simple steps at home—clean, separate, cook, and chill—to help protect you and your family from foodborne infections.
- Protect Yourself from Gonorrhea
  - Gonorrhea, a common sexually transmitted disease (STD), is becoming harder to treat due to increasing drug resistance.
  - If you are diagnosed with gonorrhea and your symptoms continue for more than a few days after receiving treatment, then return to a healthcare provider to be checked again.

Urgent Threats:

Clostridioides difficile
- Type: Bacteria
- Also known as: C. difficile or C. diff, previously Clostridium difficile
- difficile causes life-threatening diarrhea and colitis (an inflammation of the colon), mostly in people who have had both recent medical care and antibiotics
- Infections per year: 500,000*
- Deaths per year: 15,000*
Carbapenem-resistant Enterobacteriaceae (CRE)
- Type: Bacteria
- Also known as: Nightmare bacteria
- Some Enterobacteriaceae (a family of germs) are resistant to nearly all antibiotics, including carbapenems, which are often considered the antibiotics of last resort
- Drug-resistant infections per year: 9,000
- Deaths per year: 600
Drug-resistant Neisseria gonorrhoeae
- Type: Bacteria
- gonorrhoeae causes the sexually transmitted disease gonorrhea, and has progressively developed resistance to the antibiotic drugs prescribed to treat it
- Infections per year: 246,000

Here are seven facts you should know to be antibiotics aware:

Antibiotics save lives.
- When a patient needs antibiotics, the benefits outweigh the risks of side effects or antibiotic resistance.
Antibiotics aren’t always the answer.
Antibiotics do not work on viruses, such as colds and flu, or runny noses, even if the mucus is thick, yellow or green.
Antibiotics are only needed for treating certain infections caused by bacteria.
An antibiotic will not make you feel better if you have a virus.
- Respiratory viruses usually go away in a week or two without treatment.
- Ask your doctor about the best way to feel better while your body fights off the virus.
Taking antibiotics creates resistant bacteria.
- Antibiotic resistance occurs when bacteria develop the ability to defeat the drugs designed to kill them.
- Each year in the United States, at least 2 million peopleget infected with antibiotic-resistant bacteria.
  - At least 23,000 peopledie as a result.
- If you need antibiotics, take them exactly as prescribed.
  - Talk with your doctor if you have any questions about your antibiotics, or if you develop any side effects, especially diarrhea, since that could be a difficile (c. diff) infection which needs to be treated right away.