War wounded at risk for superbugs

Soldiers who survive severe injuries on battlefields such as those in Iraq and Afghanistan can be at risk from developing infections of their wounds with multidrug resistant bacteria.

The potentially lethal microbes include superbugs such as methicillin resistant Staphylococcus aureus (MRSA), Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella species and Escherichia coli.

Dr Clinton K. Murray, from Brooke Army Medical Center, USA, told the Society for General Microbiology Meeting at the International Centre, Harrogate, that at the beginning of the 20th century improved military hygiene and disease control led to a steady decline in the number of wartime deaths attributable to infections classically known as war pestilence, which included cholera, dysentery, plague, smallpox, typhoid, and typhus fever.

The development of more effective personal protective equipment, as well as training medics to provide life-saving procedures on the battlefield, has greatly improved survival rates, said Dr Murray. Positioning surgical and advanced medical care nearer to the point of injury has also enabled casualties to survive near-catastrophic wounds. But even though combat casualties are surviving these severe injuries, they risk developing wound infections. Microbes on the casualtys skin can be introduced into the wound at the time of injury or during subsequent medical care.

Although most of the infections can be treated with standard antibiotics, some of them may be caused by pathogens resistant to many if not all of these drugs. This requires clinicians to prescribe less commonly used antibiotics such as colistin. Modern microbiology and antimicrobial agents can do a lot but hospital infection control even in a war zone is of essential importance.