Forbes
June 19, 2006

War Wounds

By Matthew Herper

While working as an infectious-disease doctor on the hospital ship U.S.N.S.
Comfort in the Persian Gulf in 2003, Lieutenant Commander Kyle Petersen faced
an unexpected enemy: a killer bug called Acinetobacter baumannii. It first
showed up in an Iraqi patient who died onboard because of a mysterious bloodstream
infection. Postmortem tests revealed the culprit, a highly resistant
acinetobacter never before seen. Dr. Petersen saw the same drug-resistant infection
show up in U.S. soldiers, especially those injured by improvised roadside bombs.

Three hundred soldiers and marines have come down with the infection, which
overtakes wounds and nearby bones and can lead to amputation and pneumonia. It
has killed five noncombatant patients at Walter Reed Army Medical Center who
apparently got it from returning soldiers.

The origins of this battlefield bug remain a mystery. Soldiers may be getting
it from soil or from field hospitals in Iraq or even the big U.S. base in
Landstuhl, Germany. Acinetobacter was last prominently seen in soldiers in
Vietnam; it also turned up after the terrorist bombings in Bali and after
earthquakes in Turkey. The Iraq strain has proved particularly resistant to current
drugs, forcing docs to turn to a medicine called colistin, which is so toxic to
the kidneys that it is used only rarely.

At National Naval Medical Center in Bethesda, Md., the acinetobacter bug has
infected 10% of seriously wounded soldiers, Petersen says. Now it and other
military hospitals must halt its spread. Some have taken to swabbing the armpits
and groins of all wounded patients to see if they are colonized or infected
by the bacteria. All injured Iraq troops are put in isolation when they first
arrive at stateside military hospitals, until they are shown to be
infection-free. That seems to be helping; Petersen says the number of wounded soldiers
coming to him from Iraq with infections is down.