The Column, No. 105:

Medical Hazards to the Outdoorsman

By Dennis Johnson, MD and Carolyn Johnson, RN

At the risk of boring the reader, here are some facts we would like to pass along about adventures in the boonies. Bacteria rapidly adapt to harsh conditions, because they can reshuffle their genes in a flash and replicate in minutes. Moreover, once they have achieved the correct genetic recombination that solves their environmental problem, they can readily transfer those genes to their neighbors.

This ability has allowed them to exploit every seemingly uninhabitable ecosystem imaginable. They flourish everywhere from nuclear reactor cooling systems to barrels of crude oil.

Similarly, the indiscriminate use of antibiotics has generated resistant bacteria. First in hospitals, where MRSA, an antibiotic-resistant pathogen, emerged. It did not stop there. Many more microbes have acclimated to antibiotics, while the development of new antibacterial agents lags behind their adaptive powers.

Currently, the risk of contracting an antibiotic-resistant infection in our communities is approaching that once seen only in hospitals. How could this happen?

The proven method of producing microbial resistance is to expose the bugs to a low concentration of antibiotic. Killing microorganisms requires a sledge hammer dose of antibiotics to stop dead any possibility of genetic revival. Nonlethal levels encourage the critters to divide and conquer. That is what's happening in the countryside.

Go to any Farm, Feed and Seed store and you can buy front-line antibiotics for your pets without a prescription. Most livestock feeds contain antibiotics as a growth factor. Animals, in turn, excrete these reagents into our environment. Our soil, streams and lakes are fast becoming contaminated by low concentrations of our best antibiotics. This is a perfect situation for generating resistant species.

What is the take home message here? A hunter traversing the backwoods through brush and over barbwire fences commonly suffers nicks, cuts and abrasions, not to mention insect bites. This is where the problem can start.

Years ago, one could barefoot through chicken coop droppings with little threat of infection. Now, livestock excreta is a dilute soup of antibiotics laced with resistant bacteria. Stubbing your toe in the barnyard isn't as safe these days.

There are some nasty bugs out there and even though the probability is still low for contracting a resistant infection, why take a chance? We have seen bad infections that too often begin with what the victim considers a minor injury.

It makes good sense to treat all skin disruptions with respect. They should be thoroughly cleaned as soon as possible and bandaged securely after applying an over-the-counter topical antibiotic ointment.

Puncture wounds are especially problematic, because they may be impossible to cleanse properly. These wounds are deeper and encourage another group of organisms that multiply under low oxygen conditions. So called flesh-eating bacteria get their start in these penetrating wounds. Gangrene and tetanus are serious infections caused by this group. A good reason to keep your tetanus inoculations current.

Anytime a wound becomes red, hot and swollen, especially with a fever, it is time to seek immediate medical attention. Such lesions may require surgical treatment to avert more serious complications.

Do not take antibiotics for a cold or the flu, because they do not kill viruses. Don't take a few left over antibiotic pills from a friend when you are feeling bad. If you take an antibiotic, complete the prescribed course and do not stop when you start to feel better. All of these examples potentially expose an infection to a nonlethal dose of antibiotics.

Obviously, it is necessary to wear appropriate protective clothing when in the field, but if you suffer a minor injury, treat it promptly.

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Copyright 2016 by Dennis and Carolyn Johnson and/or All rights reserved.