Clinical Studies
Multidrug-resistant gram-negative bacilli colonization risk factors among trauma patients

https://doi.org/10.1016/j.diagmicrobio.2015.12.014Get rights and content

Highlights

  • Fourteen percent of wounded soldiers colonized with multidrug-resistant Gram-negative bacilli

  • Seventy-four percent of bacteria was extended spectrum β-lactamase–producing Escherichia coli.

  • Combat period, blood transfusion, and cefazolin use associated with colonization.

  • Additive risk for colonization when cefazolin combined with fluoroquinolones.

Abstract

Prior studies have demonstrated high rates of colonization and infection with multidrug-resistant gram-negative bacilli (MDR-GNB) in injured military personnel. Our analysis shows that injuries inflicted during peak combat periods, massive blood transfusion requirement, and posttrauma cefazolin prophylaxis (additive effect with fluoroquinolones) were risk factors for MDR-GNB colonization.

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Financial support

The authors have no conflict of interest. Support for this work (IDCRP-024) was provided by the Infectious Disease Clinical Research Program, a Department of Defense program executed through the Uniformed Services University of the Health Sciences, Department of Preventive Medicine and Biostatistics. This project has been funded by the National Institute of Allergy and Infectious Diseases, National Institutes of Health, under Inter-Agency Agreement Y1-AI-5072, and the Department of the Navy

Conflict of interest

None.

Ethical standards

The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008.

Disclaimer

The views expressed are those of the authors and do not necessarily reflect the official views of the Uniformed Services University of the Health Sciences, Henry M. Jackson Foundation for the Advancement of Military Medicine, the National Institutes of Health or the Department of Health and Human Services, Brooke Army Medical Center, Walter Reed National Military Medical Center, the US Army Medical Department, the US Army Office of the Surgeon General, the Department of Defense or the

Acknowledgments

We are indebted to the Infectious Disease Clinical Research Program Trauma Infectious Disease Outcomes Study team of clinical coordinators, microbiology technicians, data managers, clinical site managers, and administrative support personnel for their tireless hours to ensure the success of this project.

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There are more references available in the full text version of this article.

Cited by (0)

Presented in part: Infectious Disease Society of America, ID Week, October 8–12, 2014, Philadelphia, PA.

1

Current affiliation is Veterans Affairs Medical Center, Washington, DC, USA.

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