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how are problems such as mrsa and acinetobacter being addressed department of defense considerations

Potential DoD scenarios/settings increasing risk of antimicrobial resistant pathogens. SettingsTraining environmentsGarrison/U.S. military basesDoD military treatment facilities (MTF)Overseas deploymentPeacetime missionCombat operations. ID syndromes/MDR bacterial pathogen threatARIGroup A StreptococcusPneumococcusSTIN. gonorrheaeDiarrheaCampylobacterETEC/ShigellaSSTI and war woundsMRSAAcinetobacter.

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how are problems such as mrsa and acinetobacter being addressed department of defense considerations

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    1. How are problems such as MRSA and Acinetobacter being addressed? U.S. Medicine Institute for Health Studies Addressing Antimicrobial Resistance

    3. Community-associated MRSAIncident diagnoses of cellulitis/abscess at U.S. Marine Corps installations during the period, 2002-2005

    4. Community-associated Methicillin-resistant Staphylococcus aureus infections in military training/settings Outbreaks (example) MCRD Parris Island (N = 235; peak Aug-Dec 2002) MRSA colonization rate Hospital admission (4%) at Tripler AMC (Inf Control Hosp Epidemiol 2003) Ambulatory clinics (2%) at Tripler AMC (Inf Control Hosp Epidemiol 2003) Training setting (3%) at Ft. Sam Houston (Clin Infect Dis 2004) CA-MRSA infection risk MRSA-colonized personnel had 38% infection rate over 8-10 weeks (Clin Infect Dis 2004) Relative to MSSA-colonized personnel – MRSA RR 10.7 (C.I, 4.6-25.2)

    5. Community-associated Methicillin-resistant Staphylococcus aureus infections: issues for consideration Prevention Primary: hygiene measures, decolonization strategies, vaccine Secondary: recurrent infections Management Primary care management evidence-based guidance Management of recurrent infections Impact on hospital environment

    8. Multi-Drug Resistant Organisms (MDRO) and/or Trauma-Related Infection: issues for consideration Disease impact/prevention Short/long term clinical outcomes of traumatic wound infections (related to pathogen isolated, management provided, etc.) Nosocomial transmission concerns along health care delivery path (field medical to medical centers to rehabilitation centers/VA care) Natural history of gram negative MDRO pathogens (application of active surveillance approaches and contact isolation) Clinical management Clinical or laboratory predictors (colonization vs. infection) Microbiological predictors of poor outcome (e.g. in vitro resistance and/or synergy testing, virulence factors, quantitative culture) Application of optimal pharmacodynamic/pharmacokinetics principles Evidence-based management [also consider older agents (colistin)] Standardized management guidelines for war wound infections with prospective evaluation.

    9. Infectious Disease Clinical Research Program Establish/support a DoD infectious disease clinical research network Deliver a clinical research education program at USUHS

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