Some people are intimidated by antibiotic resistant bacteria, but not John McGowan. An infectious disease epidemiologist, physician, and medical microbiologist, McGowan has dedicated his career to understanding the epidemiology of antibacterial resistance as he identifies, tracks, and controls these nasty bugs. And as bacteria adopt new pathways of transmission and survival, he is there to try to thwart their success. McGowan stands on the front lines in the war against infectious disease, and each day he dedicates himself to protecting the health of the public.

McGowan began his career at Dartmouth and Harvard Medical Schools and Boston City Hospital. He then served with the Centers for Disease Control and Prevention as an Epidemic Intelligence Officer before completing a fellowship at Harvard. It was then Grady Hospital's turn for McGowan's attention. In 1973, he helped establish the infection control department at Grady, where his original focus was infection in an acute hospital setting. These experiences left him and his colleagues well-positioned for involvement in a national infection control success story in the early 1990s.

That story had its beginnings in what seemed like an isolated event—a curious case of drug-resistant tuberculosis—but quickly cascaded into a full-blown epidemic, ruthlessly targeting susceptible groups across the United States. HIV-infected patients were becoming the victims of a new strain of drug-resistant tuberculosis, including some of the patients at Grady Hospital. Control measures were rapidly developed and implemented, aided by the Centers for Disease Control and Prevention, which identified the common features of the contagion. By the mid-1990s, hospitals throughout the US had implemented effective infection control practices, and a disaster was averted.

McGowan, Professor of Epidemiology and Global Health at Emory's Rollins School of Public Health, cautions that such a success story may be harder to come by in the future. Gram-negative bacteria that cause disease, including organisms like Pseudomonas, Klebsiella pneumoniae, Acinetobacter, vancomycin-resistant enterococci (VRE), Clostridium difficile, and methicillin-resistant Staphylococcus aureus (MRSA), mainly threaten members of susceptible populations, but these organisms might soon threaten a wider pool of people because they are continuously evolving new mechanisms for survival and transmission in new hosts. New antibacterial drugs for these organisms are scarce. Yet McGowan remains optimistic about fighting gram-negative bacteria. Other than drug treatment, two tactics that build on previous successes can help: "As they become more prominent, then the strategies of isolation and infection control will become more important," he says.

Although McGowan takes a no-holds-barred approach to tackling these bacteria, he respects their ingenuity, acknowledging that "the bacteria are clever enough to have several different tools they can use to deal with the antibiotics that we expose them to. Sometimes there is a relatively easy solution to this, and sometimes not." In either case, McGowan has research strategies to combat these willful bacteria. His main focus recently has been the Intensive Care Antibiotic Resistance Epidemiology, or ICARE, Project, a collaborative study with the Centers for Disease Control and Prevention on antimicrobial resistance. ICARE evaluates the effectiveness of diagnostic tests for new resistant organisms, studies the epidemiologic relationship between use and resistance through national surveillance, and continuously looks for ways to improve recognition of bacterial strains in cheap and effective ways that are practical in clinical settings. "The idea of our lab is we can take the organisms apart and see what makes them tick, and perhaps find a way to assist clinical and public health laboratories to recognize their presence" he says.

As an innovator in infectious disease epidemiology, McGowan does not limit himself to the laboratory. He also challenges assumptions in the classroom. "I have been a practitioner, and I have had periods when a lot of my energy was devoted to research. Now, I am interested in the teaching side and bridge-building," he says. His inquiry-driven way of thinking influences his teaching method, as he prefers to challenge his students in the same way that he has been challenged throughout his war on resistant bacteria. In his Infectious Disease Epidemiology course, McGowan presents his students with a case study and then lets them think about possible causes and solutions. As the director of the MD/MPH program, he promotes creativity and the entrepreneurial spirit among his students, encouraging them to choose their own degree concentration and classes. Says McGowan: "I like students to stretch and do what they’re interested in."

Finally, he strives for collaboration and interdisciplinarity in all his undertakings. McGowan sees his assistance with the Masters of Science in Clinical Research program as a perfect opportunity to foster interdisciplinary work between the Graduate School, the School of Medicine, and Rollins School of Public Health. He is also exploring further opportunities for students within the Global Health Institute. Student opportunities have been a major focus within the ICARE Project, as McGowan gives them many opportunities to participate in cutting-edge laboratory research.

McGowan believes that Emory is a great place to take advantage of collaborative opportunities. "It has never been better," he says. "The great emphasis that was given to this from President Wagner to everyone else on down has made this a golden age for bridge-building and working together." In his view, such bridge-building is crucial for the university's flourishing in the coming decades; it is, he says, "the most important way to differentiate Emory from a lot of other places around us." It looks like this champion of infectious disease epidemiology is going to make bridge-building his new issue to tackle.