Uncommon Thought Journal: The Beginning of a MDR Epidemic?

March 4, 2007

The Beginning of a MDR Epidemic?

I was listening to the Woodruffs on Larry King the other night when Mrs. Woodruff said that Bob had almost died of a antibiotic resistant pneumonia common the the wounded troops in Iraq. That got my attention. I vaguely remembered something about this from a couple of years ago. My first thought was "that's still a problem?" It was quickly followed by "What's up with it now?"

The pneumonia, and also drug resistant inflections of wounds, catheters, and other invasive items is caused by a variant of Acinetobacter Baumannii (also known as A. baumannii). A couple of google searches turned up some interesting information, but not all that I was looking for. The MDR variant of A.baumannii seems to be relatively "common" in soldiers with battlefield wounds in both Iraq and Afghanistan. There are also various hospital reports on it in Saudi hospitals. The bacteria is found in the soil and easily contaminates typical battlefield wounds. What was not clear was where the drug resistance comes from. My guess is that it is not in the soil, but in the field hospitals - and now VA and community hospitals in the U.S.

What I could not track down was any count of how many troops have had the MDR infection; what those infections were; and how many had recovered. I also could not find if this had become a broader problem in U.S. hospitals. At least one of the articles I read stated that the bacteria had spread to community hospitals. Further, that public hospitals receiving injured troops were not being forewarned of the possible infection, nor what measures needed to be taken to contain it.

MDRs and MRSAs are bad public health news. Apparently virtually all wounded troops are being dealth with as if they are contaminated with MDR A.baumanni in the field hospitals in Iraq and Afghanistan. With the news of the disrepair of Building 18 of Walter Reed, it is clear such considerations are not being taken with those residents (at least). Many of the troops are from rural areas and small towns. If wounded are transfered back to community hospitals, contamination there could be devastating. Medical facilities are few and far between in rural America. Closing one if there is an outbreak creates a life threatening lack of medical access.

From what I read, this contamination is growing and far from contained. It appears that little is being done at community hospitals to address the issue - or even an awareness contamination may be an issue.

I am very interested in knowing 1) what is happening with troops coming home, and 2) whether this is a growing community hospital issue. This could very well turn into an "Agent Orange" or "Gulf War Syndrome" scenario, and it would be good to get ahead of the curve. We already know there is a depleted uranium problem because of US munitions (even thought the DoD denies there is a problem). The A. baumanni issue poses a larger threat to the US population. If you have any information, or come across any, please send it my way.

Below is a collection of pertinent articles

Science Daily / Yale, 3/01/07, Genome Sequence Shows What Makes Bacteria Dangerous For Troops In Iraq

Silberman, 1/22/07, Wired, The Invisible Enemy in Iraq

Brown, 11/08/06, Independent, Superbug brought back by Iraq war casualties

Effect Measure, 6/24/06, Wound infections in Iraq and here

** Mike the Mad Biologist, 8/28/05, Acinetobacter baumannii: There's a New Bug in Town

Haran, 12/22/04, Healthology, Rare Pneumonia in Iraqi Soldiers

CDC, 11/19/04, Acinetobacter baumannii Infections Among Patients at Military Medical Facilities Treating Injured U.S. Service Members, 2002--2004

Tufts: Alliance for the Prudent Use of Antibiotics, August 4, 2005, Drug-resistant Acinetobacter baumannii bacterial infections rising in American military

Cole, 7/14/04, Honolulu Adviser, Drug-resistant 'superbug' traced to war in Iraq

Conachy, 10/23/03, WSWS, 17 deaths not included in the US military pneumonia investigation