USA — Defense Department Responds to ‘Superbug’ Threat

WASHINGTON — The mil­i­tary has been a leader in rec­og­niz­ing and pro­tect­ing against the spread of mul­tidrug-resis­tant organ­isms, com­mon­ly known as “super­bugs,” defense offi­cials told Con­gress mem­bers yes­ter­day.

This strain of antibiotic-resistant Staphylococcus aureus bacteria is magnified 50,000 times
This strain of antibi­ot­ic-resis­tant Staphy­lo­coc­cus aureus bac­te­ria is mag­ni­fied 50,000 times.
CDC pho­to by Dr. Matthew J. Arduino
Click to enlarge

DOD has been active­ly engaged in mea­sures to screen, sur­veil, pre­vent and con­trol infec­tion in mil­i­tary treat­ment facil­i­ties at home and on the bat­tle­field,” Dr. Jack Smith told a House sub­com­mit­tee yes­ter­day. Smith is the act­ing deputy assis­tant sec­re­tary for clin­i­cal and pro­gram pol­i­cy in the Office of the Assis­tant Sec­re­tary of Defense for Health Affairs.

Super­bugs can cause infec­tions any­where but are espe­cial­ly dan­ger­ous when they arise and spread among hos­pi­tal patients, Smith said.

In hos­pi­tal set­tings, the infec­tions are most like­ly to con­t­a­m­i­nate sur­faces and equip­ment like ven­ti­la­tors and dial­y­sis machines; the hands of health care work­ers, vis­i­tors and fam­i­ly mem­bers; and the res­pi­ra­to­ry, uri­nary, skin and gas­troin­testi­nal tracts and wounds of hos­pi­tal­ized patients, he said.

“Health care-asso­ci­at­ed infec­tions, includ­ing those from mul­tidrug-resis­tant organ­isms, are a seri­ous prob­lem for the mil­i­tary and rep­re­sent a grow­ing prob­lem in health-care facil­i­ties across the nation,” Smith added. “These dis­ease-caus­ing organ­isms that are pre­dom­i­nant­ly bac­te­ria have increased the length of hos­pi­tal stays and mor­tal­i­ty rates.” Drug Resis­tance: A Grow­ing Threat

Drug resis­tance is the abil­i­ty of some microor­gan­isms to with­stand attack by antimi­cro­bials, includ­ing antibi­otics, accord­ing to the World Health Orga­ni­za­tion. It can come from the overuse and mis­use of antibi­otics and from the spread of resis­tant strains among peo­ple, in com­mu­ni­ties and across coun­tries.

Accord­ing to the U.S. Cen­ters for Dis­ease Con­trol and Pre­ven­tion, some com­mon drug-resis­tant organ­isms include:

— Methi­cillin-resis­tant Staphy­lo­coc­cus aureus, called MRSA, is a kind of bac­te­ria that’s resis­tant to methi­cillin, peni­cillin and oth­er antibi­otics. It was first rec­og­nized in the 1960s and now is a grow­ing prob­lem in health-care facil­i­ties and in com­mu­ni­ties.

— Van­comycin-resis­tant ente­ro­coc­ci, called VRE, are bac­te­ria present in the human intes­tine. Resis­tance devel­oped because of the mis­use of antibi­otics like van­comycin and the strain can spread from per­son to per­son.

— Mul­tidrug-resis­tant Mycobac­teri­um tuber­cu­lo­sis, called MDR-TB, is an infec­tious bac­te­r­i­al strain that arose from improp­er use of first-line or stan­dard anti-TB drugs. Exten­sive­ly drug-resis­tant (XDR-) TB aris­es when sec­ond-line or less-effec­tive TB drugs are mis­used, WHO says, cre­at­ing a strain for which treat­ment options are seri­ous­ly lim­it­ed.

“The Infec­tious Dis­ease Soci­ety of Amer­i­ca, the Insti­tute of Med­i­cine and the World Health Orga­ni­za­tion all have iden­ti­fied resis­tant infec­tious agents as major pub­lic health threats for which a coor­di­nat­ed glob­al effort is urgent­ly need­ed,” said Navy Capt. (Dr.) Gre­go­ry Mar­tin, the Navy sur­geon general’s spe­cial­ty leader for infec­tious dis­eases and a prac­tic­ing infec­tious dis­ease physi­cian at Bethes­da Naval Hos­pi­tal in Mary­land.

Health pro­fes­sion­als and researchers are con­cerned that if bac­te­ria devel­op resis­tance to all antibi­otics, health offi­cials say, no treat­ment options will exist for infect­ed patients.

Mul­tidrug-resis­tant infec­tions in com­bat injured were first iden­ti­fied in 2003, Mar­tin said, on the hos­pi­tal ship Com­fort and at Bethes­da Naval Hos­pi­tal.

Mil­i­tary Efforts

Smith said mil­i­tary health sys­tem efforts include a qual­i­ty assur­ance pro­gram imple­ment­ed in all mil­i­tary treat­ment facil­i­ties that estab­lish­es poli­cies, pro­ce­dures and train­ing pro­grams to min­i­mize reduce the risk of infec­tion to patients and staff. In fis­cal 2010, DOD spent $13.6 mil­lion on these efforts.

“We’ve estab­lished an infec­tion pre­ven­tion and con­trol pan­el with ser­vice sub­ject-mat­ter experts as a sub­com­mit­tee of our mil­i­tary health sys­tem qual­i­ty forum,” he said, and the Defense Department’s Glob­al Emerg­ing Infec­tion Sur­veil­lance and Response Sys­tem gath­ers data from par­tic­i­pat­ing mil­i­tary lab­o­ra­to­ries and hos­pi­tals world­wide to mon­i­tor poten­tial dis­ease out­breaks.

The sur­veil­lance sys­tem, estab­lished by pres­i­den­tial direc­tive in 1996, is a net­work of U.S. and over­seas lab­o­ra­to­ries whose work helps the mil­i­tary health sys­tem pre­vent, mon­i­tor and respond to infec­tious dis­eases that threat­en mil­i­tary per­son­nel and fam­i­lies and U.S. nation­al secu­ri­ty.

In the Unit­ed States, the DOD sur­veil­lance sys­tem includes the Army Cen­ter for Health Pro­mo­tion and Pre­ven­tive Med­i­cine and the Army Med­ical Research Insti­tute of Infec­tious Dis­eases in Mary­land, the Naval Health Research Cen­ter in Cal­i­for­nia, the Naval Envi­ron­men­tal Health Cen­ter in Vir­ginia and the Air Force Glob­al Sur­veil­lance Office in Texas.

The sys­tem has estab­lished work­ing rela­tion­ships with the CDC and inter­na­tion­al health agen­cies, includ­ing WHO. Over­seas, mil­i­tary lab­o­ra­to­ries in Egypt, Indone­sia, Kenya, Peru and Thai­land work with each country’s health min­istry — and some­times mil­i­taries — on dis­ease research and sur­veil­lance.

Since Decem­ber 2008, 33 mil­i­tary treat­ment facil­i­ties have par­tic­i­pat­ed in CDC’s Nation­al Health Care Safe­ty Net­work, a vol­un­tary, secure, Inter­net-based sur­veil­lance sys­tem that inte­grates patient and health-care per­son­nel safe­ty sur­veil­lance sys­tems man­aged by CDC.

DOD has also part­nered with the Vet­er­ans Admin­is­tra­tion and the CDC to address the chal­lenge of drug-resis­tant organ­isms.

“The DOD,” Mar­tin said, “has been a nation­al leader in iden­ti­fy­ing and address­ing the [mul­tidrug-resis­tant organ­ism] chal­lenge.”

Source:
U.S. Depart­ment of Defense
Office of the Assis­tant Sec­re­tary of Defense (Pub­lic Affairs)

More news and arti­cles can be found on Face­book and Twit­ter.

Fol­low GlobalDefence.net on Face­book and/or on Twit­ter

Team GlobDef

Team GlobDef

Seit 2001 ist GlobalDefence.net im Internet unterwegs, um mit eigenen Analysen, interessanten Kooperationen und umfassenden Informationen für einen spannenden Überblick der Weltlage zu sorgen. GlobalDefenc.net war dabei die erste deutschsprachige Internetseite, die mit dem Schwerpunkt Sicherheitspolitik außerhalb von Hochschulen oder Instituten aufgetreten ist.

Alle Beiträge ansehen von Team GlobDef →