For the last 15 years, improvised explosive devices better known as IEDs on the battlefield have produced massive contaminated wounds. Their slow healing nature makes the wounds more susceptible to infections with many bugs already deposited into the site at the point of the injury.
When infections occur, military medicine counters with antimicrobials. However, the use of so many drugs has led to a buildup of resistance to the treatments to cure infections.
To counteract the problem, the Multidrug-resistant organism Repository and Surveillance Network (MRSN) housed at the Walter Reed Army Institute of Research (WRAIR) www.wrair.army.mil in D.C is helping in the fight against infections. The network provides a comprehensive analysis of resistant microorganisms including genetic information.
MRSN stores the antibiotic susceptibility and genetic analyses from infectious pathogens and makes the analysis available to scientists and clinicians who can then modify treatment approaches. In addition, the information is relayed to hospitals, medical leaders, and policymakers in an effort to stem the tide of resistance transmission within the healthcare system.
MRSN works with a microbiology laboratory, organism repository, and a seven-facility network of Army hospitals, including hospitals in combat zones. MRSN has provided information to military treatment facilities in Iraq, aboard a Navy Ship, at the Walter Reed Army Medical Center, and the National Naval Medical Center. The network eventually plans to expand to include all U.S military hospitals.
Last year, the MSRN discovered a bacteria containing a gene that promotes resistance to one of the last resort antibiotics called Colistin. Shelved years ago since worrisome toxicity was an issue, Colistin was reintroduced following the increase in patients with multidrug-resistant infections with no other therapy options.
However, it has been discovered that Colistin may be losing its effectiveness in antimicrobial therapy since bacteria may be exchanging resistance genes for Colistin. Alarms sounded in the microbiology community in 2015, when the first transferrable gene for Colistin-resistance was identified in China.
It is reported that Colistin is one of the last efficacious antibiotics to treat highly resistant bacteria therefore continued surveillance is needed. Today, the global health community is monitoring and searching for the occurrence of this gene in the food supply and in humans.
This Colistin-resistance gene has been reported in Europe and Canada and now in the U.S. In one case, a clinical sample from a urinary tract infection was collected from a patient in a military treatment facility in Pennsylvania. The sample was sent to the Walter Reed National Military Medical Center (WRNMMC) www.wrnmmc.capmed.mil where Colistin susceptibility was tested. The results showed that no safe dosage of Colistin would be effective to treat this bacterial infection.