Fall 2004 Table of Contents.
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 New & Now.

Stories:

Battlefield Bacteria

The Last Word

Historic Disclosure

Genetically Altered

School for Scientists

Gravity Unbound

Papers and Profits

 

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Battlefield Bacteria

Over the course of the Iraq and Afghan wars, the deployment of high-tech surgical units and perfectly coordinated evacuation procedures have saved the lives of thousands of wounded soldiers. The heroic interventions of military doctors, nurses, corpsmen and pilots -- both at the front and at other points in the "evacuation chain" -- have been so successful, in fact, that the battlefield survival rate for wounded American service personnel now approaches 9 out of 10.

Unfortunately, a new, silent foe is stalking those wounded in Iraq and Afghanistan. Acinetobacter baumannii is one of a cluster of relatively common bacteria that, in their antibiotic-resistant forms, have emerged to threaten the lives and limbs of those already scarred by combat.

"Every war is different, but this one is unique because of the amount of explosive devices that our soldiers are encountering," says Jason Calhoun, professor and chair of MU's Department of Orthopaedic surgery. "In the last year there has been an increase in the tonnage of those devices, and the blast injuries are even worse. Over the past three years, many of our soldiers have had open fractures where both the soft tissue is injured and the bone is injured, and there is significant contamination of that tissue. Many of those soldiers go on to develop severe infections in their extremities."

By extremities, Calhoun means arms and legs, parts of the body that, along with the face, are typically left unprotected by body armor. In Iraq and Afghanistan, he says, some 70 percent of all injuries involve extremities, and close to half of these wounds end up infected with antibiotic-resistant bugs. For such cases, additional treatments and surgeries are necessary. Often soldiers end up with amputated limbs. Some die.

As awareness of the threat has increased, so has the effort of scientists to combat the resistant bacteria. For his part, Calhoun, the recent recipient of a $1.6-million grant from the U.S. Army Institute of Surgical Research, is working with researchers at Walter Reed Army Medical Center in Washington, D.C., and Brooke Army Medical Center in Fort Sam Houston, Texas, to build a database of multi-drug resistant bacteria.

The study will also include lab tests to be conducted at the MU School of Medicine that will use simulated blast wounds to examine infections resulting from four of the most dangerous bacteria. These are the aforementioned Acinetobacter baumannii, along with Pseudomonas aeruginosa, Klebsiella pneumoniae and Staphylococcus aureus.

The data will allow doctors and epidemiologists to analyze real-world cases with an eye toward identifying the most dangerous organisms, then work out new treatments and ways to determine how these treatments might be administered without creating next-generation antibiotic resistance in the bacteria.

"Ultimately," Calhoun says, "this research could mean fewer extremity infections, fewer surgeries and fewer amputations."

       
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