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Infections in the Military

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As Veterans Affairs hospitals have started adopting innovative measures including antimicrobial silver for soft surface intervention as a key infection prevention tool, it’s a good time to take a look at infections in the military.

While technologies have been employed to increase survival rates, “infection remains a significant complication in combat-related injuries”. However, in the Journal of Trauma, Hospenthal et. al. have noted the prominence of multidrug-resistance pathogens even overtaking combat-related injury infections, with infections emerging from “deployed medical treatment facilities through chain of care outside the combat zone”.

Origin of Infections

Environmental conditions can influence the prevalence of infections in the military. For example, confined areas for military personnel (i.e., barracks) lend themselves to skin and soft tissue infections, including severe infections like “PVL-associated Staphylococcus aureus pneumonia or Streptococcus pyogenes necrotizing fasciitis, with mortality rates of up to 65% and 30%, respectively”. These close quarter conditions are also “ripe environments for the establishment, persistence, and spread of CA-MRSA.”

Climate can also play a factor in infections, with bacterial and fungal infections occurring more commonly in the “hot and humid climates of Vietnam and East Timor”.

How about soft surfaces?

Soft surfaces and textiles, as fomites, are another high area of concern for infection spread. In a study conducted at a large military hospital, home laundered uniforms (including military uniforms) showed a significantly higher degree of bacterial contamination versus hospital laundered uniforms. Even more interesting, military uniforms in this study showed an increase in nosocomial infection risk factors.

Response to Infections

No matter the type of infection, it is important to implement a comprehensive approach to infection control and provide continuous hygiene at point of care, whether in the barracks, field, or hospital. A key component in this layered approach to infection control should be inclusion of protocols for soft surfaces and textiles.