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Genesis of Clinical Microbiology in the CSH - Afghanistan 2002 LTC John M. Scherer Ph.D., M.T. ( ASCP ) PowerPoint Presentation
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Genesis of Clinical Microbiology in the CSH - Afghanistan 2002 LTC John M. Scherer Ph.D., M.T. ( ASCP ). HISTORY. May 2002 Outbreak of unknown illness among British soldiers Unknown etiology Critically ill Spreading person-to-person 44 th MEDCOM responsible for HCO

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slide1

Genesis of Clinical Microbiology

in the CSH - Afghanistan 2002

LTC John M. Scherer

Ph.D., M.T. (ASCP)

slide2

HISTORY

  • May 2002
    • Outbreak of unknown illness among British soldiers
    • Unknown etiology
    • Critically ill
    • Spreading person-to-person
  • 44th MEDCOM responsible for HCO
    • Currently no CSH in Afghanistan
    • Concern over inability to ID any infectious diseases
    • 520th TAML had the capability but not all the components
    • Three-person team deployed July 2002 met up with 339th CSH in August
slide3

MISSION

To deploy the developmental M403 Microbiology Augmentation Set to Bagram Air Force Base in Afghanistan, work out supply issues, train the 339th CSH in its use, and redeploy back to COUNS for future deployment to Kuwait.

slide4

CAPABILITIES

  • Culture: Wounds, Blood, Stools, Urine, Respiratory, Fluids, etc.
  • Antibiotic Susceptibilities: GNR & GPC (- Strep pneumo)
  • RAPID tests: Group A Strep, Influenza, Strep pneumo, some Protozoa
  • O&P
  • Direct Fungal Staining
  • Malaria Staining
slide5

ITEMS NOT PART OF THE KIT

  • Mycobacterium staining or culture
  • Anaerobe identification
  • Fungal identification
slide12

Demographics of Microbiology Workload

452nd Combat Support Hospital, Bagram Afghanistan

(April 1, 2003 to Mar 15, 2004)

slide13

Most commonly isolated organisms from 452nd Combat Support Hospital, Bagram Afghanistan

(April 1, 2003 to Mar 15, 2004).

*These 12 organisms account for approximately 85% of the total number of positive cultures.

slide14

Most common isolated organisms based on culture type

452nd Combat Support Hospital, Bagram Afghanistan

(April 1, 2003 to Mar 15, 2004).

slide15

ESBL activity as measured by

Ceftazidime resistance

Annals of Clinical Microbiology and Antimicrobials 2004; 3:7

Journal of Antimicrobial Chemotherapy 2000; 45: 295-303

slide16

E. Coli Susceptibility Pattern

Annals of Clinical Microbiology and Antimicrobials 2004; 3:7

Antimicrobial Agents and Chemotherapy 2001; 1402–1406

slide17

CLINICAL CONCLUSIONS

  • Overall, the set performed exceptionally well
  • Susceptibility patterns are different than those observed in the US
  • Some tests will not provide the same performance as they do in the US
  • Gram negative rods were frequently isolated from blast wounds (not Acinetobacter)
slide18

IMPACT BEYOND PATIENT CARE

  • Maintain soldiers with local knowledge in theater
  • Decreases casualty movement/decreased logistical burden
  • Mission readiness
    • - Bacterial versus viral meningitis
slide19

America's Deployable Medical Command

Questions

Special Thanks to CPT Scott Cvecko for the data from the 452nd CSH