Hundreds of acinetobacter infections a year with wounded soldiers

Insurgents in the Bloodstream
Proceedings Capt. Chas Henry (Ret.) February 22, 2008
"It's why I lost my leg, so it sucks."

The assessment, from a 22-year-old Marine toughing out physical therapy on two prosthetic limbs, is laconic, matter-of-fact. Sgt. David Emery lost one leg in February 2007 when a suicide bomber assaulted the checkpoint near Haditha, Iraq, where he and fellow Marines stood guard. Military surgeons were forced to remove his remaining leg when it became infected with acinetobacter baumannii-a strain of highly resistant bacteria that since U.S. forces began fighting in Iraq and Afghanistan has threatened the lives, limbs, and organs of hundreds wounded in combat.

"They could have saved it," says Emery. "They had a rod in it, but then the bacteria was in too bad and my white blood cell count was up to 89,000-and they told my mom on a Friday that they had to take it."

Emery's mother recalls that the hazard was not confined to her son's limbs.

"He ended up getting it in his stomach," says Connie Emery, "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."

An Army infectious disease physician says the germ has spread rapidly since the wars in Afghanistan and Iraq began. "Prior to the war, we were seeing one to two cases of acinetobacter infection per year," remembers Lt. Col. Kimberly Moran, deputy director for tropical public health at the Uniformed Services University of the Health Sciences in Bethesda, Maryland.

"Now that's much different. We've had hundreds of positive cultures over the last four years."

And the toll has been serious, observes Army Col. Glenn Wortmann, acting chief of infectious disease at Walter Reed Army Medical Center in Washington, D.C. "Of the infectious disease problems that have come out of the conflict," notes Dr. Wortmann, "it is the most important complication we've seen."
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