Soldiers wounded in Iraq plagued by mysterious bacteria

[rainbow4321]

http://www.dallasnews.com/sharedcontent/dws/dn/latestnews/stories/093007dnnatiraqbacteria.3328a9b.html

The young American army medic would not stop bleeding. He had been put on a powerful regimen of antibiotics by doctors aboard the hospital ship Comfort in the Persian Gulf. But something was wrong.

<snip>

It was April 2003, early in the Iraq war, and, 4 1/2 years later, scientists still are struggling to understand the medical mystery.

<snip>

Hundreds of patients – the military says it doesn't know how many – have been infected with the bacterium. Many were troops wounded in Iraq or Afghanistan; others have been civilians infected after stays in military hospitals.

At least 27 people have died with Acinetobacter infections since 2003, although doctors are uncertain how many of the deaths were actually caused by the bacteria.

[MADem]

1. Nasty shit, that

The three cases aboard the Comfort were the first of a stubborn outbreak that has since spread to at least five other American military hospitals, including Walter Reed Army Medical Center in Washington, D.C., and the Army's Landstuhl Regional Medical Center in Germany. ...How the bacteria became entrenched in the field hospitals is still unknown. But, in many ways, it is irrelevant. It is there, and, as civilian hospitals have found, it is not going away easily.

For the most part, doctors have figured out the most effective drugs against the bacterium – an antibiotic called imipenem and an older class of drugs known as polymyxins.

The drugs have made the infections fairly manageable. Through stricter controls, such as monitored hand-washing, infections rates have begun to show signs of dropping in some hospitals.

Dr. Petersen, who worked at National Naval Medical Center in Maryland after the Comfort's mission ended, treated just one or two cases of Acinetobacter infections in July, a dramatic decline from the highs of 15 to 20 a month in 2004 and 2005. So far this year, there have been less than a handful of cases each month, according to hospital figures.

Acinetobacter, it turns out, might only be a marker of vulnerability. "It is not the worst bug," Dr. Murray said.

Recently, scientists have noted signs that Acinetobacter strains are growing resistant to polymyxins and imipenem.

[pinto]

2. Overview of Acinetobacter, via CDC:

Overview of Drug-resistant Acinetobacter Infections in Healthcare Settings
Released: September 24, 2004

What is Acinetobacter?

Acinetobacter is a group of bacteria commonly found in soil and water. It can also be found on the skin of healthy people, especially healthcare personnel. While there are many types or “species” of Acinetobacter and all can cause human disease, Acinetobacter baumannii accounts for about 80% of reported infections.

Outbreaks of Acinetobacter infections typically occur in intensive care units and healthcare settings housing very ill patients. Acinetobacter infections rarely occur outside of healthcare settings.

What are the symptoms of Acinetobacter infection?

Acinetobacter causes a variety of diseases, ranging from pneumonia to serious blood or wound infections and the symptoms vary depending on the disease. Typical symptoms of pneumonia could include fever, chills, or cough. Acinetobacter may also “colonize” or live in a patient without causing infection or symptoms, especially in tracheostomy sites or open wounds.

How do people get Acinetobacter infection?

Acinetobacter poses very little risk to healthy people. However, people who have weakened immune systems, chronic lung disease, or diabetes may be more susceptible to infections with Acinetobacter.Hospitalized patients, especially very ill patients on a ventilator, those with a prolonged hospital stay, or those who have open wounds, are also at greater risk for Acinetobacter infection. Acinetobactercan be spread to susceptible persons by person-to-person contact, contact with contaminated surfaces, or exposure in the environment.

How is Acinetobacter infection treated?

Acinetobacter is often resistant to many commonly prescribed antibiotics. Decisions on treatment of infections with Acinetobacter should be made on a case-by-case basis by a healthcare provider. Acinetobacter infection typically occurs in very ill patients and can either cause or contribute to death in these patients.

What should I do to prevent the spread of Acinetobacter infection to others?

Acinetobacter can live on the skin and may survive in the environment for several days. Careful attention to infection control procedures such as hand hygiene and environmental cleaning can reduce the risk of transmission. For more information on infection control practices and hand hygiene, see Hand Hygiene in Healthcare Settings and Guideline for Isolation Precautions in Hospitals.

Date last modified: September 24, 2004

Content source:
Division of Healthcare Quality Promotion (DHQP)
National Center for Preparedness, Detection, and Control of Infectious Diseases

http://www.cdc.gov/ncidod/dhqp/ar_acinetobacter.html

[Avalux]

3. About Acinetobacter baumannii -

It's found in the soil and water (and on the skin of healthcare workers; normally only infects those with weakened immune systems. Considered a hospital-acquired infection until those in Iraq started coming home with the 'superbug' version - Gram negative bacillus; previously sensitive antibiotics are resistant. Now we're seeing it in the community among healthy individuals. Manifests as a variety of ways including serious wound infections, blood infections and pneumonia.

I have personal knowledge of several cases at Brooke Army Medical Center; it's hit and miss with every imaginable combination of antibiotics; sometimes they simply do not work.

http://www.acinetobacter.org/