An outbreak of drug-resistant wound infections among soldiers in
The outbreak of drug-resistant Acinetobacter baumannii-calcoaceticus complex (ABC) infections among
Historically, ABC infections were treated with a wide variety of drugs. Unfortunately, in recent years, strains of Acinetobacter have been emerging that are resistant to nearly all known remedies. The ABC infections found among the
Between March and October 2003, researchers from the Army and the Centers for Disease Control and Prevention identified 145 inpatients at
They found ABC in only one out of 49 soil samples and just one out of 160 samples from soldiers' skin. By contrast, ABC organisms were found in the patient treatment areas of all seven field hospitals sampled. The authors therefore concluded that environmental contamination of field hospitals and transmission within health care facilities played a major role in this outbreak.
The authors noted the possibility that the infections were acquired outside the hospital cannot be ruled out completely due to limitations in the available samples from soil, patients, and field hospitals. However, they concluded, "The most likely source of this outbreak was bacteria within deployed field hospitals," says author Clinton K. Murray, MD, of the
Field hospitals by their nature present a challenging environment for infection control. As temporary structures in desert conditions, thorough cleaning is difficult. "The frequent influxes of large numbers of casualties over short periods of time increases the risk of environmental contamination with Acinetobacter and challenges the implementation of standard infection control practices," the authors observed. However, they wrote, "Based upon these findings, maintaining infection control throughout the military health care system is essential." They add that military hospital staffs in the
"The increased emphasis on infection control procedures within military facilities in the U.S. has greatly limited the nosocomial transmission within military hospitals in the U.S.," Murray adds.
Source: Infectious Diseases Society of America (IDSA)