February 18, 2008

Completely Drug Resistant Acinetobacter baumannii

A forty nine year old woman has died from completely drug resistant Acinetobacter baumannii in a New Orleans hospital. Another patient on the same floor died from it also.
The hospital admitted that the bacteria was contracted in the hospital, that they had tested it for every drug susceptibility and that it was resistant to them all.
The family was told there was nothing more they could do and the woman died.

February 11, 2008

Epidemic-Middle East-Iraq Leishmaniasis


Over 180 children have been affected with Baghdad boil disease, or leishmaniasis, in Iraq's southern province of Qadissiyah, about 130km south of Baghdad, local officials said. Leishmaniasis is known by different local names, including oriental sore, Aleppo button, Jericho boil and Delhi boil. In its most unpleasant form - visceral leishmaniasis - organ failure and death can result. The disease's incubation period is up to six months, so thousands could have the disease without knowing it. "It is a dangerous disease which hits mostly children and could lead to death or leave skin deformities if no appropriate treatment is available," said Fatih Abdul-Salam, a dermatologist at Qadissiyah General Hospital. He said leishmaniasis is transmitted by the bite of the midge-like female phlebotomine sandflies - tiny sand-coloured blood-sucking flies. "The disease has spread because of the lack of medical measures in the province and the lack of medicines, as most of those available have expired," Abdul-Salam said.

According to the World Health Organization (WHO), the currently-used drugs are in any case toxic, and have severe adverse reactions. They are also very costly. Nearly half of the current cases are in the Siniya area, about 15km west of Qadissiyah's provincial capital, Diwaniyah. "About a month ago, we informed the provincial officials about the spread of this disease in our area and that we did not have enough medicines for it," said Farhan Mohammed, the head of Siniya local council. "But no one responded in a serious way and that contributed to the spread of this disease, as our modest efforts in the area's medical centre were not enough," Mohammed said. According to WHO, the 20 or so infective species or subspecies of the parasite cause a range of symptoms, some of which are common (fever, malaise, weight loss, anaemia) - and swelling of the spleen, liver and lymph nodes in its visceral form. Cutaneous leishmaniasis - the most common form - causes 1-200 simple skin lesions which self-heal within a few months but which leave unsightly scars. Mucocutaneous leishmaniasis begins with skin ulcers causing massive tissue destruction, especially of the nose and mouth.

Dutch military battling Acinetobacter baumannii

RNW Press Review – 25 January 2008 - by David Doherty

The Dutch army found itself battling a new enemy yesterday in the east of the Netherlands. "Soldiers in action against resistant bacteria" is the headline in AD, which features a front-page photo of servicemen and women in full camouflage gear setting up an emergency intensive care facility in a hospital car park in the province of Twente.

Two intensive care patients at the hospital were found to be infected with the rare Acinetobacter baumannii bacteria, which - like the more common hospital bug MSRA - is resistant to most antibiotics. The two are now in isolation and a sign reading "do not enter unless absolutely necessary" has been slapped on the rest of the ward.

The 14 patients currently on the ward will stay put. "We can only start disinfecting when the last patient has been discharged ... which could take up to three months depending on their condition," explained a hospital spokesman.

New intensive care patients will go to the military containers in the car park. AD reports that "there is a similar intensive care unit at the Dutch military camp in Afghanistan". "So we've got the experience to get everything set up quickly," adds one of the soldiers with a wink.


January 17, 2008

Ongoing Problems at Walter Reed


Ongoing Problems at Walter Reed
By Matt Renner
t r u t h o u t | Interview

Tuesday 15 January 2008

"Nothing has changed [at Walter Reed]. Same facility. None of the recommendations that I made have been implemented and to my knowledge they really aren't working on it."
Former Army Lt. and military nurse Doug Connor sat down for an interview with Truthout reporter Geoffrey Millard to share his experience before and after the Walter Reed Medical Center scandal broke.

Encouraged by the firings of top military officials as a result of the problems at Walter Reed, Connor spoke out about the dilapidated conditions at Walter Reed. He sent a letter to Gen. Gregory A. Schumacher with recommendations for improving conditions in the Intensive Care Unit (ICU) where there were equipment shortages and outbreaks of infectious bacteria, including extremely dangerous drug-resistant forms of Acinetobacter baumannii, a bacterium that has been ravaging injured soldiers in Iraq and in domestic military hospitals.

The infection problems caused other units within the hospital to lose faith in the ICU's ability to care for surgical patients. Because of the infections, "the kidney transplant team will not recover their patients in the surgical ICU anymore," Connor said in the interview.

According to Connor, his recommendations were not acted upon. Instead, he claims that he was retaliated against. "I thought he would thank me for letting him know where there were areas that needed to be fixed ... I have been retaliated against because of the letters that I have sent out. It is pretty transparent ... Everyone that has seen what happened around me is just like 'yeah, they're going after you.'"


University of Maryland Acinetobacter baumannii Outbreak

Still promoting the myth that only sick people get this.

Deadly Infection in Baltimore Hospital

Three patients from a Baltimore hospital are dead – after becoming infected with deadly, drug-resistant bacteria.

On January 4th, officials at the University of Maryland Medical Center discovered that the three patients had been infected with “Acinetobacter baumannii.” It is not clear whether the patients actually died from that infection; hospital officials say all three patients were already very ill, and had been hospitalized for several weeks.

Still, the hospital is taking serious precautions. “Unfortunately, this organism -- and other organisms -- appear in many hospitals in Baltimore and beyond on an ongoing basis. That is why we have a proactive and comprehensive infection control and surveillance system in place,” said Ellen Beth Levitt, a spokeswoman for the University of Maryland Medical Center.

Four other patients identified as having the organism are still being cared for in the unit and are in stable condition, Levitt said. They have been separated from other patients and they are being treated by a team with strict contact precautions in force, including the use of gloves and gowns, frequent hand washing and frequent disinfection of medical equipment and facilities. No new patients are being admitted to that unit for the time being, she said.

Acinetobacter baumannii is best-known for affecting military personnel who have been serving in Iraq or Afghanistan. The bacteria can live on surfaces like countertops, medical equipment and even cell phones for up to 12 days. Most strains are difficult to treat, because they are not affected by common antibiotics. However, the infection poses little risk to healthy people. It can cause a variety of illnesses, ranging from pneumonia to serious blood or wound infections. Acinetobacter may also colonize or grow in a patient without causing infection or symptoms.

January 10, 2008

Iraq Field Hospitals Using Untested Blood

I have previously mentioned that soldiers and medical staff were donating blood on the spot in field hospitals in Iraq. Even if they had time to test it they don't test it for leishmaniasis which has at times been at epidemic proportions in Baghdad and elsewhere.
I have always wondered if my husbands leishmaniasis came from the blood he recieved at the field hospital Dogwood.
The UK soldiers that received untested blood from the US Field Hospitals are likely just the tip of iceburg when it comes to wounded soldiers and contractors being repatriated without being tested for contagious pathogens.

More here




January 3, 2008

Iraq War Veteran still battling a stubborn foe

Iraq War Veteran Still Battling a Stubborn Foe


Article Launched: 01/03/2008 11:31:06 AM EST

BENNINGTON - Former Bennington resident William Krawczyk thought he was returning home from his second tour of duty in Iraq unharmed. It turned out, however, that his battle was just beginning.
Krawczyk, 46, a first sergeant in the Army Reserves, now lives in Erie, Pa. Once the epitome of good health, he is now very sick, suffering from Methicillin-resistant Staphylococcus aureus, a skin infection that has grown resistant to antibiotics.

Krawczyk was on his second deployment in Iraq in May 2005 when he noticed what appeared to be a welt on one of the fingers on his right hand. It soon transformed into a painful blister. Doctors drained the blister, put him on antibiotics and he returned to service.

About a month later, however, Krawczyk said he developed a cyst on his left hand. Doctors again drained it, but this time sent a sample off for testing. It showed that showed Krawczyk had MRSA. He was put on vancomycin, a powerful antibiotic, to no avail. In Dec. 2005, Krawczyk said another cyst developed on his stomach.

Krawczyk soon left Iraq and returned to Erie when his tour of duty ended in Jan. 2006. But just one week after his return he noticed a new cyst on his left hand. New "unbelievable painful" cysts continued
appear and doctors continued to drain them, he said.
"I have three new ones this week," Krawczyk said Wednesday after returning from a visit with one of his doctors.

But that's not all. His immune system began to fail, too. He has met with doctors at the Cleveland Clinic and the Walter Reed Army Medical Center, but no one can tell him why.

"The problem is the doctors don't know what's wrong with me. They can't pinpoint what's wrong," Krawczyk said. "I don't know if they're ever going to find out what's wrong with me."

Krawczyk has his own theory. He believes he was bitten by a spider, but adds that his doctors have not been able to determine that. "When I first went to the Air Force hospital they thought it was a spider," he said.

Krawczyk said his body began producing abnormally high amounts of white blood cells, which help the body fight infections. "They don't know where to fight the infection in my body," he said. "Usually, I get sick every few weeks. I can't fight infections anymore."

Soon, Krawczyk, who speaks in a quiet, labored tone, was unable to continue working as a production manager for Alltel. His arms and legs began to swell to twice their size and he started to feel constantly fatigued.

The Army is covering most of the medical expenses, but his ailments have caused strain on his family's finances, Krawczyk said. His wife must take time off from work to help him get to his medical appointments. The loss of income has caused the couple to dip into their savings.

"When I have to travel they don't pay for my wife's time off from work. I can't drive long distances," he said.

Krawczyk and his wife and their two children have suffered emotionally as well, but his family has been supporting him, he said. "My family is pretty strong. We're just tired. We want some answers," he said.

Krawczyk said he has hope that doctors will find some medical explanation - and cure - for his ailment. "What else is there to do?" he said.

But he's also frustrated with how his life has progressed since coming home from Iraq. Krawczyk is now on intravenous fluids twice a day to receive his antibiotics. He takes medication to settle his stomach, and a handful of pills every six hours.

"What life? I'm so drugged up I don't know where I'm at. It's horrible," Krawczyk said. "The infection is beating me to a pulp." Krawczyk's father, Albert Krawczyk, who lives in Bennington, said his son hasn't been able to travel back home for nearly two years. Albert and his wife traveled to Erie for Thanksgiving, though, to visit.

"Here we have a young man that is walking with a cane, can't do anything," Albert Krawczyk said. "He's full of ulcers."

The hardest part of the ordeal, for Albert Krawczyk, has been seeing his youngest son fighting an unknown enemy.

"It's sad that somebody goes over and comes back like this. Basically, (my son) says that if he was shot and lost a leg he'd be better off than having this," the elder Krawczyk said.

Despite his constant pain and struggle, Krawczyk said he is "absolutely" happy with the care he has received from the Army and has no regrets.

"I have no regrets being in the military, and I have no regrets going over there and serving my country," he said.