1176. Rapidly-growing mycobacteria in combat-wounded soldiers: an emerging infection
Session: Poster Abstract Session: Mycobacteria Other Than Tuberculosis
Saturday, October 22, 2011
Room: Poster Hall B1
Handouts
  • IDSA2011POSTER1176.pdf (1.1 MB)
  • Background: Polymicrobial wound infections are a common complication among US service members with traumatic blast injuries. Infections from multi-drug resistant bacteria are well documented and invasive fungal infections have been previously reported.  Here we describe the clinical and microbiologic findings of infection with rapidly growing mycobacteria (RGM).

    Methods:  Case series of 3 patients with traumatic bone and soft tissue infections treated at Walter Reed Army Medical Center between September 2010 and March 2011.

    Results: We identified 3 inpatients from Walter Reed Army Medical Center (WRAMC) with RGM wound (n=2) and wound plus bone (n=1) infections. All had sustained blast injuries from an improvised explosive device during dismounted operations in Afghanistan. All suffered from traumatic amputation, requiring radical revision to include hemi-pelvectomy in 2 cases.  Infection with M. chelonae/abscessus (n=2) and M. fortuitum complex (n=1) were isolated and exhibited typical drug susceptibility patterns. RGM were recovered from AFB cultures submitted only after treatment for multiple bacterial and fungal infections. Successful management required susceptibility-directed antibiotic therapy in addition to multiple surgical debridements.  No cases had been seen at WRAMC or reported in the literature prior to these cases.

    Conclusion: Rapidly growing mycobacterium wound infections may represent an emerging complication of combat injuries sustained during dismounted operations during war. Clinicians should consider RGM in the microbiologic differential diagnosis of poorly healing bone and soft tissue infections associated with blast injuries.


    Subject Category: C. Clinical studies of bacterial infections and antibacterials including sexually transmitted diseases and mycobacterial infections (surveys, epidemiology, and clinical trials)

    Robert Paris, MD1, Leyi Lin, MD1, Omolara Alao, MD1, Joshua Hartzell, MD2, Michael Zapor, MD, PhD1 and Roseanne Ressner, DO1, (1)Infectious Diseases, Walter Reed Army Medical Center, Washington, DC, (2)Infectious Disease, Walter Reed Army Medical Center, Washington, DC

    Disclosures:

    R. Paris, None

    L. Lin, None

    O. Alao, None

    J. Hartzell, None

    M. Zapor, None

    R. Ressner, None

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