Insurgents in the Bloodstream, Part II
posted 7:40 pm Tue November 27, 2007 - Washington
Dr. Rox Anderson, Harvard Medical School: "You have complex wounds: combination of burns, blast injury, lacerations and then - on top of that - they get infected."
And studies show they most likely become infected in the frontline hospitals that save their lives, but do so in less-than-sterile conditions. Chas Henry: "One doctor I spoke with, who chose not to appear on camera, said if you thought of every hospital along the casualty evacuation chain as one large health care system, this constitutes the largest outbreak of this sort in history."
Lt. Col. Kimberly Moran, Army Physician: "It was spread from patient to patient through various means, just being on surfaces and having one person come in a room after another person has left."
The few truly effective treatments come with possibility of such side effects as kidney failure. One is an antibiotic called Colistin.
Col. Glenn Wortmann, Army Physician: "It hadn't been used really since the 1970's. I had never used it ever, until the last couple years. And the concern with Colistin was that it would cause kidney damage or nerve damage."
Because tests to prove infection take days, doctors agonize over whether to treat or wait and see. Dr. Rox Anderson, Harvard Medical School: "The infection if it goes on sometimes will lead to amputation, so these are tough choices."
Adding to military surgeons' challenge: trying to not remove tissue that's not infected.
Lt. Col. Kimberly Moran, Army Physician: "Doing everything they can to get rid of the devitalized tissue without taking too much in the way of good, viable tissue and preserving limb length for a prosthetic - that's a tough call."
Twenty-two-year-old David Emery had already lost one leg to a bomb blast. Then acinetobacter infected his other.
David Emery, Wounded Marine: "They could have saved it. They had a rod in it, but then the bacteria's in too bad and my white blood cell count was up to eighty-nine thousand, and they told my mom on a Friday that they had to take it."
And it wasn't just his leg.
Connie Emery, Mother of Wounded Marine: "He ended up getting it in his stomach, and they tried to close his stomach back up, but when they did, the stitches ended up pulling away because the infection was taking over."
Sometimes trying to err on the side of caution; doctors on the frontline prescribe wide-spectrum antibiotics from the very start - perhaps not the best way to fight acinetobacter.
Cmdr. Kyle Petersen, Navy Physician: "I think antibiotic use is probably driving some of this because when you keep people on prolonged antibiotics unnecessarily, it lets them be colonized with worse and worse bacteria."
Col. Glenn Wortmann, Army Physician: "When you give an antibiotic, you'll kill most of the bacteria that's on that patient. But if a bacteria either is resistant to that antibiotic or is able to rapidly become resistant to that antibiotic, then it will grow because all the other bacteria have been killed off."
In the final installment on Wednesday: Have defense officials been slow to address this dangerous dilemma?
CLICK HERE for Part I
CLICK HERE for Part III
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