Antimicrobial resistance of enteric pathogens in the Military Health System, 2009 – 2019

BMC Public Health

Research

Nicholas Seliga¹  Uzo Chukwuma¹  Myles Johnson²  Kenji Matsumoto³  Upendra Bhattarai⁴  Paul Graf⁵  Mona Baishya⁶  Connor D. Pomeroy⁶  Sara Bazaco⁷  Kathleen Creppage⁷  Hayley Ashbaugh⁸ 

[1] Defense Centers for Public Health - Portsmouth, 620 John Paul Jones Circle, Suite 1100, 23704, Portsmouth, VA, USA;Deloitte Consulting LLP, 1919 N Lynn St Suite 1500, 22209, Rosslyn, VA, USA;Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Defense Centers for Public Health - Portsmouth, Portsmouth, United States;ManTech International Corporation, Defense Centers for Public Health - Portsmouth, Portsmouth, United States;Naval Health Research Center, San Diego, CA, USA;Present Address: Naval Medical Research Unit No. 6, Lima, Peru;Oak Ridge Institute for Science and Education, Defense Centers for Public Health - Portsmouth, 620 John Paul Jones Circle, Suite 1100, 23704, Portsmouth, VA, USA;Public Health Directorate, Armed Forces Health Surveillance Division, Global Emerging Infections Surveillance Branch, 11800 Tech Road, 20904, Silver Spring, MD, USA;Walter Reed Army Institute of Research, U.S. Army Medical Research Directorate-Georgia, 99 Kakheti Highway, 0198, Tbilisi, Georgia;

关键词: Enteric pathogens;    Antimicrobial resistance;    Infectious disease surveillance;    Salmonella;    Shigella;    Campylobacter;    Escherichia coli;   

DOI  :  10.1186/s12889-022-14466-1

 received in 2021-07-09, accepted in 2022-10-27,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundAcute diarrhea (AD) can have significant impacts on military troop readiness. Medical providers must understand current trends of enteropathogen antimicrobial resistance (AMR) in service members (SMs) to inform proper, timely treatment options. However, little is known of enteric pathogen profiles across the Military Health System (MHS). The primary objectives of this study were to identify gaps in enteric pathogen surveillance within the MHS, describe the epidemiology of AMR in enteric pathogens, and identify trends across the MHS both within the Continental United States (CONUS) and outside of the Continental United States (OCONUS).MethodsHealth Level 7 (HL7)-formatted laboratory data were queried for all specimens where Salmonella, Shigella, and Campylobacter species, as well as Shiga toxin-producing Escherichia coli (E. coli) (STEC) were isolated and certified between 1 January 2009 - 31 December 2019. Antibiotic susceptibility testing (AST) results were queried and summarized where available. Descriptive statistics were calculated for each organism by specimen source, year, and susceptibility testing availability.ResultsAmong a total of 13,852 enteric bacterial isolates, 11,877 (86%) were submitted from CONUS locations. Out of 1479 Shigella spp. and 6755 Salmonella spp. isolates, 1221 (83%) and 5019 (74%), respectively, reported any susceptibility results through the MHS. Overall, only 15% of STEC and 4% of Campylobacter spp. specimens had AST results available. Comparing AST reporting at CONUS versus OCONUS locations, AST was reported for 1175 (83%) and 46 (78%) of Shigella isolates at CONUS and OCONUS locations, respectively, and for 4591 (76%) and 428 (63%) of Salmonella isolates at CONUS and OCONUS locations, respectively.ConclusionsThis study revealed inconsistent enteropathogen AST conducted across the MHS, with differing trends between CONUS and OCONUS locations. Additional work is needed to assess pathogen-specific gaps in testing and reporting to develop optimal surveillance that supports the health of the force.

【 授权许可】

CC BY   
© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2022

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