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Emergence of Multidrug Resistance in Bacteria and Impact on Antibiotic Expenditure at a Major Army Medical Center Caring for Soldiers Wounded in Iraq and Afghanistan

Published online by Cambridge University Press:  02 January 2015

Michael J. Zapor*
Affiliation:
Departments of Medicine, Infectious Disease Service, Walter Reed Army Medical Center, Washington, D.C
Daniel Erwin
Affiliation:
Pathology, Infectious Disease Service, Walter Reed Army Medical Center, Washington, D.C
Goldina Erowele
Affiliation:
Pharmacy, Infectious Disease Service, Walter Reed Army Medical Center, Washington, D.C
Glenn Wortmann
Affiliation:
Departments of Medicine, Infectious Disease Service, Walter Reed Army Medical Center, Washington, D.C
*
Infectious Disease Service, Dept. of Medicine, Walter Reed Army Medical Center, 6900 Georgia Ave., Washington, DC 20307 ([email protected])

Abstract

Since the invasions of Iraq and Afghanistan, the epidemiologic traits of clinical isolates at Walter Reed Army Medical Center have shifted toward drug-resistant strains of microorganisms, particularly among the gram-negative bacteria. Moreover, antibiotic prescribing patterns during this period have changed remarkably and mirror the emergence of these organisms at our institution.

Type
Concise Communications
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2008

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References

1.Owens, BD, Kragh, JF, Macaitis, J, Svoboda, SJ, Wenke, JC. Characterization of extremity wounds in Operation Iraqi Freedom and Operation Enduring Freedom. J Orthop Trauma 2007;21:254257.Google Scholar
2.Murray, CK, Roop, SA, Hospenthal, DR, et al. Bacteriology of war wounds at the time of injury. Mil Med 2006;171:826829.CrossRefGoogle ScholarPubMed
3.Petersen, K, Riddle, MS, Danko, JR, et al. Trauma-related infections in battlefield casualties from Iraq. Ann Surg 2007;245:803811.Google Scholar
4.Johnson, EN, Burns, TC, Hayda, RA, Hospenthal, DR, Murray, CK. Infectious complications of open type III tibial fractures among combat casualties. Clin Infect Dis 2007;45:409415.CrossRefGoogle ScholarPubMed
5.Scott, P, Deye, G, Srinivasan, A, et al. An outbreak of multidrug-resistant Acinetobacter baumanii-cakoaceticus complex infection in the US military health care system associated with military operations in Iraq. Clin Infect Dis 2007;44:15771584.Google Scholar
6.Paolino, K, Erwin, D, Padharia, V, et al. In vitro activity of colistin against multidrug resistant gram-negative bacteria isolated at a major Army hospital during the military campaigns in Iraq and Afghanistan. Clin Infect Dis 2007;45:140141.Google Scholar
7.Perez, F, Endimiani, A, Hujer, KM, Bonomo, RA. The continuing challenge of ESBLs. Curr Opin Pharmacol 2007;7:459469.CrossRefGoogle ScholarPubMed
8. Reported cases of syphilis, the United States, 1941–2002. (Adapted from Centers for Disease Control and Prevention. STD Surveillance, September 2002). Tramont, EC. Treponema pallidum (Syphilis). In: Principles and Practice of Infectious Diseases.6th ed. Philadelphia: Churchill Livingstone; 2000:27682785.Google Scholar
9.McCormick, JB, Sexton, DJ, McMurray, JG, Carey, E, Hayes, P, Feldman, RA. Human-to-human transmission of Pseudomonas pseudomallei. Ann Intern Med 1975;83:512513.Google Scholar
10.Weina, PJ, Neafie, RC, Wortmann, G, Polhemus, M, Aronson, NE. Old World leishmaniasis: an emerging infection among deployed US military and civilian workers. Clin Infect Dis 2004;39:16741680.Google Scholar