title: Multidrug-resistant gram-negative bacteria colonization of healthy US military personnel in the US and Afghanistan.
abstract: BACKGROUND
  The US military has seen steady increases in multidrug-resistant (MDR) gram-negative bacteria (GNB) infections in casualties from Iraq and Afghanistan. This study evaluates the prevalence of MDR GNB colonization in US military personnel.
  
  
  METHODS
  GNB colonization surveillance of healthy, asymptomatic military personnel (101 in the US and 100 in Afghanistan) was performed by swabbing 7 anatomical sites. US-based personnel had received no antibiotics within 30 days of specimen collection, and Afghanistan-based personnel were receiving doxycycline for malaria chemoprophylaxis at time of specimen collection. Isolates underwent genotypic and phenotypic characterization.
  
  
  RESULTS
  The only colonizing MDR GNB recovered in both populations was Escherichia coli (p=0.01), which was seen in 2% of US-based personnel (all perirectal) and 11% of Afghanistan-based personnel (10 perirectal, 1 foot+groin). Individuals with higher off-base exposures in Afghanistan did not show a difference in overall GNB colonization or MDR E. coli colonization, compared with those with limited off-base exposures.
  
  
  CONCLUSIONS
  Healthy US- and Afghanistan-based military personnel have community onset-MDR E. coli colonization, with Afghanistan-based personnel showing a 5.5-fold higher prevalence. The association of doxycycline prophylaxis or other exposures with antimicrobial resistance and increased rates of MDR E. coli colonization needs further evaluation.
authors: Brooke Army Medical Center/San Antonio Military Medical Center, Fort Sam Houston, TX, USA.
authors: Todd J
authors: TJ
authors: Vento
authors: David W
authors: DW
authors: Cole
authors: Katrin
authors: K
authors: Mende
authors: Tatjana P
authors: TP
authors: Calvano
authors: Elizabeth A
authors: EA
authors: Rini
authors: Charla C
authors: CC
authors: Tully
authors: Wendy C
authors: WC
authors: Zera
authors: Charles H
authors: CH
authors: Guymon
authors: Xin
authors: X
authors: Yu
authors: Kristelle A
authors: KA
authors: Cheatle
authors: Kevin S
authors: KS
authors: Akers
authors: Miriam L
authors: ML
authors: Beckius
authors: Michael L
authors: ML
authors: Landrum
authors: Clinton K
authors: CK
authors: Murray
mesh_terms: D000328:Adult; D000346:Afghanistan / Q000453:epidemiology; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology; D024901:Drug Resistance, Multiple, Bacterial; D004926:Escherichia coli / Q000187:drug effects* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D008889:Military Personnel; D015995:Prevalence; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
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