Exclusive: Insurgents in the Bloodstream
posted 7:40 pm Mon November 26, 2007 -
Since the beginning of the Iraq war, this bloodstream insurgent - acinetobacter baumannii - has been threatening the lives and health of men and women wounded in combat.
David Emery, Wounded Marine: "That's why I lost my leg, so it sucks." A suicide bomber took one of David Emery's legs. Acinetobacter infection took the other.
Cmdr. Kyle Peterson, Navy Physician: "We've never had a problem like this in the Department of Defense hospitals that I know of before."
Lt. Col. Kimberly Moran, Army Physician: "Prior to the war, we were seeing one to two cases of acinetobacter infection per year, now that's much different. We've had hundreds of positive cultures over the last four years now."
Col. Glenn Wortman, Army Physician: "Of the infectious disease problems that have come out of the conflict, it is the most important complication we've seen."
At first, researchers thought bomb blasts blew the bacteria into penetrating wounds. That's what they told Connie Emery had happened to her 22-year-old son David.
Connie Emery, Mother of Wounded Marine: "They explained that that's what it was, and it comes from the soil over there, and there's no antibiotic that will cure it."
But examination of soil samples didn't seem to support the "it's in the dirt" theory.
Cmdr. Kyle Peterson, Navy Physician: "Acinetobacters that grow in dirt are not the ones that cause these outbreaks in hospitals."
Additional tests showed that most soldiers didn't seem to have the bacteria on their skin before they were hurt. So infectious disease specialists swabbed surfaces in medical facilities along casualty evacuation routes - from Baghdad to Landstuhl, Germany to D.C. and San Antonio.
Lt. Col. Kimberly Moran, Army Physician: "There were bacteria, acinetobacter bacteria, on hospital surfaces like in operating rooms, on ventilator machines or on light surfaces or environmental control units."
How did it get there?
Complex surgery is being done closer to front lines than ever before - saving the lives of many who, in previous wars, would have died. But amidst multiple, bloody and hectic operations, it's difficult to keep treatment centers germ-free.
Dr. Rox Anderson, Harvard Medical School: "And in the process there's not a hundred percent of the controls despite a great effort by the military medical people, there's a high risk of infection anyway."
Cmdr. Kyle Petersen, Navy Physician: "Transmission from forward hospitals was certainly part of the problem."
A problem made tougher by acinetobacter's particular genius: stealing resistance capabilities from all other bacteria around it.
Lt. Col. Kimberly Moran, Army Physician: "It's this smart that it could put together this resistance island that makes it resistant to almost every antibiotic we have available."
Chas Henry: Facing a bug resistant to many current antibiotics, doctors and patients are sometimes forced to turn to toxic cures that might kill the bacteria but could risk additional harm to a soldier's health. And to guess, because test results come back slowly, whether bacteria have merely colonized on the patient's skin or actually gotten into a wound.
Cmdr. Kyle Petersen, Navy Physician: "If it's colonized and I over-treat him, I could damage his kidneys. If he's infected, and I ignore that and say he's colonized, he could die."
Tuesday, on Federal News Today: details on the dangerous dilemmas of treating soldiers and marines infected with acinetobacter - from those who've faced it first-hand.
CLICK HERE for Part II
CLICK HERE for Part III
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