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August
4, 2005
THE NEW YORK TIMES
TROOPS IN IRAQ BRING RESISTANT BACTERIA HOME
By DENISE GRADY
American
troops wounded in Iraq and brought back to military hospitals
in the United States have unexpectedly high rates of infection
with a drug-resistant type of bacteria, doctors are finding.
The bacteria,
Acinetobacter baumannii, are not unique to Iraq. They live
in soil and water in many parts of the world, and had already
been known to cause trouble in hospitals and on battlefields in
Vietnam. They can invade wounds, the bloodstream, bones, the lungs
and other parts of the body. Antibiotics can cure the infection,
but doctors must use the right ones, which include amikacin and
imipenem.
"It is
not difficult to treat," said Col. Bruno Petruccelli, a physician
and director of epidemiology and disease surveillance for the
United States Army Center for Health Promotion and Preventive
Medicine. "If the antibiotic works, it works easily. It easily
dies." But, he added, an especially resistant strain of bacteria
can cause a prolonged infection.
About
240 cases have been treated at Army hospitals since 2003, Colonel
Petruccelli said. Hospitals like Walter Reed now see 6 to 12 infected
soldiers a month; before 2003 they had no more than one a month.
An online
publication, Forbes.com, described the current outbreak on Tuesday,
and reported that about 40 infected patients had been treated
at the National Naval Medical Center in Bethesda, Md., in the
same time period. A spokesman for the hospital did not respond
to telephone messages on Wednesday.
No American
soldiers from the Iraq war have died from the bacteria, but five
very ill patients in the same hospitals as wounded soldiers became
infected in the hospital and subsequently died. It is not known
whether the bacteria or the patients' underlying illnesses caused
their deaths, Colonel Petruccelli said.
He said
healthy people can harbor the bacteria on their skin for a long
time, and may spread them to others. Doctors can infect patients
if they fail to wash their hands and clean stethoscopes and blood
pressure cuffs after treating infected people. Patients who are
chronically ill or have weakened immune systems are especially
vulnerable to the infection.
The bacteria
pose a challenge because they have natural defenses that let them
fight off many antibiotics, and they are also good at improvising
ways to outfox new drugs that are thrown at them, said Dr. Arjun
Srinivasan, a medical epidemiologist with the Centers for Disease
Control and Prevention. In addition, he said, they are extremely
hardy, and in one experiment proved capable of living on surfaces
for up to 20 days. That makes them a menace in hospital rooms,
where they can lurk on bed rails, tables and other furnishings
and infect one patient after another unless every item in the
room is thoroughly disinfected. "If you have a patient with a
large wound with a lot of Acinetobacter in it, there's
a high chance of contaminating the environment," Dr. Srinivasan
said.
Dr. Andrew
Shorr, a pulmonary and critical care specialist at the Washington
Hospital Center who recently worked at Walter Reed Army Medical
Center, said: "It has implications for our Veterans Affairs system.
If our soldiers bring it into the hospitals, the system will have
to be very diligent with infection control."
Copyright
2005 The New York Times Company.
This material is distributed in accordance with Title 17 U.S.C.
Section 107.
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