Multidrug-resistant gram-negative bacteria colonization of healthy US military personnel in the US and Afghanistan

BMC Infectious Diseases

Clinton K Murray⁵  Michael L Landrum²  Miriam L Beckius¹  Kevin S Akers³  Kristelle A Cheatle¹  Xin Yu¹  Charles H Guymon³  Wendy C Zera²  Charla C Tully¹  Elizabeth A Rini¹  Tatjana P Calvano¹  Katrin Mende²  David W Cole⁴  Todd J Vento⁵ 

[1] Brooke Army Medical Center/San Antonio Military Medical Center, Fort Sam Houston, TX, USA;Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, MD, USA;United States Army Institute of Surgical Research, Fort Sam Houston, TX, USA;Blanchfield Army Community Hospital, Fort Campbell, KY, USA;Uniformed Services University of the Health Sciences, Bethesda, MD, USA

关键词: Escherichia coli;    ESBL-production;    Environment exposure;    Malaria chemoprophylaxis;    Deployment;   

Others  :  1158439
DOI  :  10.1186/1471-2334-13-68

 received in 2012-08-04, accepted in 2013-01-29,  发布年份 2013

【 摘 要 】

Background

The US military has seen steady increases in multidrug-resistant (MDR) gram-negative bacteria (GNB) infections in casualties from Iraq and Afghanistan. This study evaluates the prevalence of MDR GNB colonization in US military personnel.

Methods

GNB colonization surveillance of healthy, asymptomatic military personnel (101 in the US and 100 in Afghanistan) was performed by swabbing 7 anatomical sites. US-based personnel had received no antibiotics within 30 days of specimen collection, and Afghanistan-based personnel were receiving doxycycline for malaria chemoprophylaxis at time of specimen collection. Isolates underwent genotypic and phenotypic characterization.

Results

The only colonizing MDR GNB recovered in both populations was Escherichia coli (p=0.01), which was seen in 2% of US-based personnel (all perirectal) and 11% of Afghanistan-based personnel (10 perirectal, 1 foot+groin). Individuals with higher off-base exposures in Afghanistan did not show a difference in overall GNB colonization or MDR E. coli colonization, compared with those with limited off-base exposures.

Conclusion

Healthy US- and Afghanistan-based military personnel have community onset-MDR E. coli colonization, with Afghanistan-based personnel showing a 5.5-fold higher prevalence. The association of doxycycline prophylaxis or other exposures with antimicrobial resistance and increased rates of MDR E. coli colonization needs further evaluation.

【 授权许可】

   
2013 Vento et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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