The Invisible Enemy

Wired has an excellent article out today about Acinetobacter baumannii. Why on Earth, you might ask, would I want to read an article about bacteria?

Well, primarily because it points out that soldiers who survive combat are not always assured of physical safety. Silent enemies lurk everywhere. The evacuation system for soldiers fighting in Iraq is plagued with multi-drug resistant bacteria that can not only kill, but be passed on to others. This has been a problem in other conflicts: one of the major vectors of transition for the 1914-1918 flu, for example, was military hospitals.

During an evacuation of a wounded soldier, the primary concern is to get ou physically stable and to a hospital where more extensive treatments can be provided. Major wounds are dealt with, broken bones are set, the soldier is pumped full of antibiotics, and then packaged to be sent to Germany, and then on to the United States. In an environment where there are a high volume of casualties, it is very difficult to take basic infection precautions. The most important thing is the life of that soldier, right?

Well…yes…and no. By slacking on infection prevention protocol because of limitations posed by staff and facilities, combat hospitals are setting up a great environment for bacteria to breed in. Rapidly packaging men and women for treatment at other facilities sets up a situation where all sorts of bacteria are bundled with the patient. These bacteria, in turn, are brought to each hospital along the chain.

Acinetobacter is an interesting little organism. Like a lot of bacteria that can potentially cause highly dangerous infections, it lives harmlessly on the skin of healthy individuals. When it encounters someone with a compromised immune system, however, it goes to town, colonizing the body. Many strains being found today are resistant to treatment, leading to a bacterial infection that is essentially incurable. The organism also thrives in hostile environments, so it can wait for a long time to find a suitable victim.

The Department of Defense has been trying to keep the Acinetobacter problem on the down low. It might lower morale, after all, to think of soldiers being infected by essentially incurable bacterial illnesses. It also might reveal serious weak points in the way we organize and provide treatment for wounded soldiers. The infection was not spread by evil bioweapons masterminds, or the natural Iraqi sand: it was spread by our own well meaning medical personnel, and now it’s become a global problem. A bit embarassing for the DoD, eh?