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Iraq war casualties often complicated

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12:23pm, October 18, 2005
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From San Francisco, at a meeting of the Infectious Diseases Society of America

Hundreds of injured soldiers returning from the conflicts in Iraq and Afghanistan harbor an unusual bacterium that complicates their wound healing and may be spreading to other patients in hospitals where the soldiers are treated, a new study shows. Moreover, the microbe seems to be lingering in soldiers, cropping up during rehabilitation care received months after they have returned to the United States.

Paul M. Scott, a physician at the Walter Reed Army Institute of Research in Silver Spring, Md., and his colleagues isolated the bacterium, called Acinetobacter baumannii, from 148 wounded soldiers returning from Iraq and Afghanistan between November 2002 and September 2003. Since then, more than 100 additional wounded combatants have been diagnosed with A. baumannii.

Many of the A. baumannii strains found in these soldiers don't match those occurring naturally in Iraqi soil, Scott notes. Their origins are "murky," he says.

A. baumannii can cause pneumonia and infect the urinary tract and blood, says Walter E. Stamm, a physician at the University of Washington in Seattle and president of the Infectious Diseases Society of America.

The infection also slows wound healing. It responds to antibiotic treatment, and none of the combat casualties so far has died from the infection. However, 18 people in the United States and Germany who weren't in active service but were being treated in the same hospitals as the infected soldiers who have also been found to be infected with A. baumannii. Five of these other patients have died, Scott says.

Richard L. Oehler, a physician at the James A. Haley Veterans Hospital in Tampa, Fla., reports that seven of the nine wounded soldiers admitted there for rehabilitation between June 2004 and January 2005 harbored A. baumannii strains that were resistant to certain commonly used antibiotics. One soldier has died, and the others have recovered.

"This is an unusual bacterium that has not been seen frequently as a cause of disease in U.S. hospitals," Stamm says. "Once it's introduced into a hospital, it can be difficult to get rid of."

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