Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 11, Number 8—August 2005
Research

Multidrug-Resistant Acinetobacter Extremity Infections in Soldiers

Kepler A. Davis*Comments to Author , Kimberly A. Moran†, C. Kenneth McAllister*, and Paula J. Gray*
Author affiliations: *Brooke Army Medical Center, Fort Sam Houston, Texas, USA; †Walter Reed Army Medical Center, Washington, DC, USA

Main Article

Table 1

Acinetobacter osteomyelitis*

Patient Osteomyelitis location Mechanism of injury MDR isolate Bacteremia Hardware Parenteral drug therapy Follow on oral antimicrobial agents Recurrent infection Follow-up, wk†
1 Left radius/ulna Landmine explosion, driver of pavement grater Yes No Yes Imipenem 500 mg every 6 h, amikacin 20 mg/kg/d for 8 wk No Secondary infection with MSSA 12
2 Right humerus/shoulder IED round through shoulder Yes No Yes Imipenem 500 mg every 6 h, amikacin 15 mg/kg/d for 6 wk Yes, ciprofloxacin 500 mg 2 × a day No 32
3 Right humerus/shoulder IED blast, shrapnel injury Yes No Yes Imipenem 500 mg every 6 h, amikacin 15 mg/kg/d for 7 wk No No 35
4 Left radius/ulna Gunner in APC who received RPG blast Yes Yes No Imipenem 500 mg every 6 h for 7 wk, with amikacin 20 mg/kg/d for 3 wk changed to amp/sulb 3 g every 6 h for 4 wk No No 4
5 Left tibia Mortar blast, shrapnel injuries Yes No No Ceftazidime 2 g every 8 h; amikacin 12.5 mg/kg/d for 7 wk No No 7
6 Right distal humerus/elbow Passenger in HMMWV, roadside IED blast Yes No Yes Imipenem 500 mg every 6 h for 7 wk No Secondary infection with Enterobacter cloacae 22
7 Left tibia/fibula Proximate IED blast Yes No Yes Amp/sulb 12 g continuous 24-h infusion for 6 wk No No 36
8 Left humerus Proximate mortar round blast Yes Yes No Meropenem 1 g every 8 h for 7 wk No No 5
9 Left tibia/fibula Driver of Humvee, hit land mine Yes No No Gentamicin 5 mg/kg/d for 3 wk No No 40
10 Left distal humerus/elbow Truck driver, IED blast Yes No Yes Imipenem 500 mg every 6 h for 6 wk No Yes—secondary pin tract infection, No culture 30
11 Right humerus/shoulder Gunner in HMMWV, IED blast Yes No No None No No 39
12 Right humerus/elbow HMMWV passenger, IED blast No No Yes Imipenem 500 mg every 6 h, amikacin 15 mg/kg/d for 6 wk No Secondary infection with MRSA 48
13 Left tibia 50-caliber gunshot wound No No No Amp/sulb 3 g every 6 h, amikacin 20 mg/kg/d for 6 wk Yes—amox/clav 875/125 mg 2 ×/d for 3 wk Secondary infection with MSSA 61
14 Left humerus/elbow Motor vehicle accident, elbow out window, no blast injury No No Yes Imipenem 500 mg every 6 h, gentamicin 5 mg/kg/d for 4 d Yes—levofloxacin 500 mg/d for 10 d No 57
15 Right femur Passenger HMMWV, RPG round to right leg No Yes No Imipenem 500 mg every 6 h, amikacin 20 mg/kg/d for 6 wk No No 9
16 Left tibia Gunshot wound to left leg No No No Imipenem 500 mg every 6 h, amikacin 15 mg/kg/d for 8 wk No No 35
17 Right tibia/fibula Passenger HMMWV, IED blast, open fracture No No No Imipenem 500 mg every 6 h for 4 wk, followed by meropenem 1 g every 8 h for 2 more wk No Secondary infection with MRSA 50
18 Left tibia Motor vehicle accident, run over by tank No No No Ceftazidime 2 g every 8 h for 4 wk No No 56

*MDR, multidrug resistant; MSSA, methicillin-sensitive Staphylococcus aureus; IED, improvised explosive device; APC, armored personnel carrier; RPG, rocket-propelled grenade; HMMWV, high mobility multipurpose wheeled vehicle, also known as Humvee; MRSA, methicillin-resistant S. aureus; Amp/sulb, ampicillin/sulbactam; Amox/clav, Amoxicillin + clavulanic acid.
†Length of follow-up after completion of antimicrobial drug therapy.

Main Article

Page created: April 23, 2012
Page updated: April 23, 2012
Page reviewed: April 23, 2012
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external