Multidrug-resistant bacterial colonization of combat-injured personnel at admission to medical centers after evacuation from Afghanistan and Iraq.

Background: Multidrug-resistant organism (MDRO) infections, including those secondary to Acinetobacter (ACB) and extended spectrum β-lactamase (ESBL)-producing Enterobacteriaceae (Escherichia coli and Klebsiella species) have complicated the care of combat-injured personnel during Operations Iraqi Freedom and Enduring Freedom. Data suggest that the source of these bacterial infections includes nosocomial transmission in both deployed hospitals and receiving military medical centers (MEDCENs). Admission screening for MDRO colonization has been established to monitor this problem and effectiveness of responses to it.

Response to infection control challenges in the deployed setting: Operations Iraqi and Enduring Freedom.

Background: Infections caused by multidrug-resistant organisms (MDROs), including Acinetobacter, have complicated the care of military personnel injured in Operations Iraqi and Enduring Freedom. Cumulative data suggest that nosocomial transmission of MDROs in deployed medical treatment facilities (MTFs) has contributed to these infections. A 2008 review of deployed MTFs identified multiple factors impeding the performance of infection prevention and control (IC) practices.

Natural history of colonization with gram-negative multidrug-resistant organisms among hospitalized patients.

Objective: To determine the anatomic sites and natural history of colonization with gram-negative multidrug-resistant organisms (MDROs).

Design: Prospective, longitudinal cohort study.

Setting: Walter Reed Army Medical Center, a 236-bed tertiary care center in Washington, DC.