Emergence of multidrug resistance in bacteria and impact on antibiotic expenditure at a major army medical center caring for soldiers wounded in Iraq and Afghanistan.
Since the invasions of Iraq and Afghanistan, the epidemiologic traits of clinical isolates at Walter Reed Army Medical Center have shifted toward drug-resistant strains of microorganisms, particularly among the gram-negative bacteria. Moreover, antibiotic prescribing patterns during this period have changed remarkably and mirror the emergence of these organisms at our institution.
Zapor
Michael J
MJ
Department of Medicine, Infectious Disease Service, Walter Reed Army Medical Center, Washington, DC 20307, USA. Michael.Zapor@amedd.army.mil
Erwin
Daniel
D
Erowele
Goldina
G
Wortmann
Glenn
G
D000346:Afghanistan; D000900:Anti-Bacterial Agents / Q000191:economics* / Q000494:pharmacology / Q000627:therapeutic use*; D024901:Drug Resistance, Multiple, Bacterial; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000302:isolation & purification; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D006095:Gram-Positive Cocci / Q000187:drug effects; D006772:Hospitals, Military; D006801:Humans; D015994:Incidence; D007493:Iraq; D008826:Microbial Sensitivity Tests; D008889:Military Personnel; D010818:Practice Patterns, Physicians'; D014481:United States; D014857:Warfare
D000900:Anti-Bacterial Agents