Evaluation of Disinfectants on Military NATO and DECON Litters (Research AND REPORTS‪)‬

Reports in the literature cite an increase in Acinetobacter baumannii infections among patients at military medical facilities treating US service members who have been injured in Iraq and Afghanistan. Two medical centers, Landstuhl Regional Medical Center and Walter Reed Army Medical Center, identified 102 patients with blood cultures positive for A. baumannii during the period January 1, 2002-August 31, 2004. The two medical centers had a combined total of three cases of A. baumannii positive blood culture during the previous two years. (1) Brooke Army Medical Center (BAMC) reported twenty-three soldiers wounded in Iraq and subsequently admitted to BAMC who had wounds that were culture positive for A. baumannii during the period of March 2003 to May 2004. Eighteen of the twenty-three patients had osteomyelitis which had not been identified at BAMC during the 14 months preceding March 2003. (2) Studies involving environmental and colonization cultures indicate that the source of the A. baumannii infections may be nosocomial in origin. A study conducted at BAMC that included 293 soldiers with no history of deployment and who were not healthcare workers found no Acinetobacter nares colonization in any of the participants, indicating that A. baumannii nares colonization in a normal healthy population is very low. (3) A study assessing the bacteriology of war wounds at the time of injury sampled 61 separate acute traumatic injury wounds from 49 casualties upon arrival at the 31st Combat Support Hospital in Baghdad. The study revealed a predominance of gram positive organisms of low virulence and pathogenicity. No multi-drug resistant gram negative organisms were recovered. (4) A study conducted in Iraq and Kuwait by the Walter Reed Army Institute of Research found skin colonization in only 1 of 160 patients who were screened and in only I of 49 soil samples, but A. baumannii-calcoaceticus complex isolates were recovered from treatment areas in all seven of seven field hospitals sampled. (5)