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Multidrug-Resistant and Virulent Organisms Trauma Infections: Trauma Infectious Disease Outcomes Study Initiative
Katrin Mende1,2,3, Kevin S Akers4, Stuart D Tyner5
1Infectious Disease Clinical Research Program, Preventive Medicine & Biostatistics Department, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.
Military Medicine
|May 5, 2022
Summary
Combat wound infections are complicated by multidrug-resistant (MDR) organisms and polymicrobial presence. The TIDOS MDR/VO Initiative identified key microbial threats, informing strategies to improve combat casualty care.
Area of Science:
- Infectious Diseases
- Microbiology
- Trauma Surgery
Background:
- Combat trauma infections present challenges due to multidrug-resistant (MDR) organisms and polymicrobial wounds.
- The Trauma Infectious Disease Outcomes Study (TIDOS) investigates MDR and wound microbiology in combat casualties.
Purpose of the Study:
- To establish the TIDOS MDR and Virulent Organisms Trauma Infections Initiative (MDR/VO Initiative) for comprehensive microbiological research.
- To improve understanding of the etiology of combat-related wound infections and identify potential countermeasures.
Main Methods:
- Collected over 8,300 isolates from military personnel injured in Iraq and Afghanistan between June 2009 and December 2014.
- Analyzed antimicrobial susceptibility, antagonism, and biofilm formation of wound bacteria, including ESKAPE pathogens.
- Retained isolates in the TIDOS Microbiological Repository with associated clinical data.
Main Results:
- Nearly one-third of collected isolates were MDR; 12% of wounded warriors were colonized with MDR Gram-negative bacilli upon admission.
- MDR Gram-negative bacterial infections occurred in 27% of combat casualties with infections.
- Sixty-one percent of extremity wound infections were polymicrobial, with Escherichia coli being the most common MDR Gram-negative bacillus and Enterococcus spp. frequent in polymicrobial infections.
Conclusions:
- The TIDOS MDR/VO Initiative provides critical data on microbial threats in combat wounds.
- Findings enhance understanding of wound infection etiology and support the development of infectious disease countermeasures.
- This research aims to improve clinical outcomes for combat casualties.