Multidrug-resistant organisms in military wounds from Iraq and Afghanistan

Area of Science:

• Military medicine
• Infectious diseases
• Orthopaedic surgery

Background:

• Historically, battlefield wound mortality has decreased due to advances in surgical care, rapid transport, and antibiotics.
• A current challenge in military medicine is combating multidrug-resistant organisms (MDROs) in extremity wounds.
• Key resistant bacteria include Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter calcoaceticus-baumannii complex.

Purpose of the Study:

• To highlight the challenge of MDROs in military orthopaedic extremity wounds.
• To identify prevalent resistant bacterial strains.
• To underscore the need for further research in combating these infections.

Main Methods:

• Review of current challenges in military wound care.
• Identification of common multidrug-resistant bacterial strains.
• Analysis of potential contributing factors to resistance.

Main Results:

• Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter calcoaceticus-baumannii complex are frequently identified resistant strains.
• Overuse of broad-spectrum antibiotics is a potential factor in the development of resistance.
• Acinetobacter infections are often hospital-acquired rather than initial colonizations.

Conclusions:

• MDROs present a critical threat in military orthopaedic extremity wounds.
• Effective strategies are needed to reduce infection rates and combat resistant organisms.
• Additional research is essential to equip military physicians with tools to manage these infections.