The present study examined the degree to which morally injurious experiences (MIEs; i.e., atrocities of war, psychological consequences of war, and leadership failure/betrayal) and moral injury (i.e., guilt, shame, difficulties with forgiveness, and withdrawal associated with exposure to MIEs) were associated with symptoms of depression, anxiety, posttraumatic stress disorder (PTSD), suicidality, hazardous alcohol use, and drug abuse symptoms. In addition, we examined moral injury and PTSD symptoms as mediators of the association between MIEs and these outcomes (exploratory model). Participants (n = 244) were a predominantly veterans community-based military sample. Our primary model (i.e., single mediation model) revealed that moral injury mediated associations between two MIEs (i.e., atrocities of war and leadership failure/betrayal) and depressive symptoms, anxiety symptoms, hazardous alcohol use, and PTSD symptoms. However, our exploratory model (i.e., a dual simultaneous mediation model) revealed that moral injury was not significantly associated with any health outcomes after controlling for the effects of MIE dimensions and PTSD symptoms. Within this model, PTSD symptoms significantly mediated the effects of both atrocities of war MIEs and leadership failure/betrayal MIEs on depressive symptoms, anxiety symptoms, suicidality, and hazardous alcohol use. Findings provide preliminary support for moral injury as a mechanism linking exposure to MIEs to both mental health and hazardous alcohol use. Taken together, moral injury appears to be an important target for intervention among combat military personnel.

Staphylococcus aureus (SA) is a commensal bacterium and opportunistic pathogen commonly associated with humans and is capable of causing serious disease and death including sepsis, pneumonia, and meningitis. Methicillin-resistant SA (MRSA) isolates are typically resistant to many available antibiotics with the common exception of vancomycin. The presence of vancomycin resistance in some SA isolates combined with the current heavy use of vancomycin to treat MRSA infections indicates that MRSA may achieve broad resistance to vancomycin in the near future. New MRSA treatments are clearly needed. Bacteriophages (phages) are viruses that infect bacteria, commonly resulting in death of the host bacterial cell. Phage therapy entails the use of phage to treat or prevent bacterial infections. In this study, 12 phages were isolated that can replicate in human SA and/or MRSA isolates as a potential way to control these infections. 5 phage were discovered through mitomycin C induction of prophage and 7 others as extracellular viruses. Primary SA strains were also isolated from environmental sources to be used as tools for phage discovery and isolation as well as to examine the target cell host range of the phage isolates by spot testing. Primary isolates were tested for susceptibility to oxacillin in order to determine which were MRSA. Experiments were performed to assess the host range and killing potential of newly discovered phage, and significant reductions in bacterial load were detected. We explored the utility of some phage to decontaminate fomites (glass and cloth) and found a significant reduction in colony forming units of MRSA following phage treatment, including tests of a phage cocktail against a cocktail of MRSA isolates. Our findings suggest that phage treatment can be used as an effective tool to decontaminate human MRSA from both hard surfaces and fabrics.

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