title: Prevention of combat-related infections: antimicrobial therapy in battlefield and barrier measures in French military medical treatment facilities.
abstract: Infection is a major complication associated with combat-related injuries. Beside immobilization, wound irrigation, surgical debridement and delayed coverage, post-injury antimicrobials contribute to reduce combat-related infections, particularly those caused by bacteria of the early contamination flora. In modern warfare, bacteria involved in combat-related infections are mainly Gram-negative bacteria belonging to the late contamination flora. These bacteria are frequently resistant or multiresistant to antibiotics and spread through the deployed chain of care. This article exposes the principles of war wounds antimicrobial prophylaxis recommended in the French Armed Forces and highlights the need for high compliance to hygiene standard precautions, adapted contact precautions and judicious use of antibiotics in French deployed military medical treatment facilities (MTF).
authors.affiliation: Biology Department and Infection Control Unit, Bégin Military Hospital, 69 avenue de Paris, 94160 Saint-Mandé, France. Electronic address: merens-a@wanadoo.fr.
authors.forename: Audrey
authors.initials: A
authors.lastname: Mérens
authors.affiliation: Infectious Diseases Department, Bégin Military Hospital, 69 avenue de Paris, 94160 Saint-Mandé, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Rapp
authors.affiliation: Biology Department and Infection Control Unit, Bégin Military Hospital, 69 avenue de Paris, 94160 Saint-Mandé, France.
authors.forename: Deborah
authors.initials: D
authors.lastname: Delaune
authors.affiliation: Orthopaedic Surgery Department, Percy Military Hospital, 101 avenue Henri Barbusse, 92140 Clamart, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Danis
authors.affiliation: Epidemiology and Public Health Department CESPA, Camp de Sainte-Marthe, 408 rue Jean Queillau, 13014 Marseille, France.
authors.forename: Franck
authors.initials: F
authors.lastname: Berger
authors.affiliation: Epidemiology and Public Health Department CESPA, Camp de Sainte-Marthe, 408 rue Jean Queillau, 13014 Marseille, France.
authors.forename: Remy
authors.initials: R
authors.lastname: Michel
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D005602:France; D006772:Hospitals, Military; D006801:Humans; D017053:Infection Control / Q000379:methods*; D008887:Military Medicine / Q000379:methods*; D008889:Military Personnel; D014946:Wound Infection / Q000188:drug therapy / Q000517:prevention & control
chemical_list: D000900:Anti-Bacterial Agents
keywords: Combat-related infection; Multidrug resistant organisms; Post-injury antibiotics; Standard precautions; War wounds