Multidrug-Resistant Chronic Osteomyelitis Complicating War Injury in Iraqi Civilians

Introducing an antibiotic stewardship program in a humanitarian surgical hospital

“…5 Existing orthopedic infection was found to be common in patients at program entry, and the prevalence of multidrug-resistant pathogens was high. 6,7 To optimize management of chronic trauma-related infections, a medical-surgical strategy was established, a collaboration with a local microbiology laboratory was developed, and broad-spectrum antibiotics, including glycopeptides (vancomycin), extendedspectrum aminoglycosides (amikacin), and carbapenems (imipenem), active against multidrug-resistant strains, were introduced for the first time in an MSF hospital. However, in the absence of support for optimized prescribing practices, broad-spectrum antibiotic use increased, opportunities for parenteral to oral antibiotic transitions were missed, unnecessarily postsurgical antibiotic prophylaxis was sometimes given, and as a result overall program costs escalated.…”

Antimicrobial Drug–Resistant Bacteria Isolated from Syrian War–Injured Patients, August 2011–March 2013

“…The source of antimicrobial drug–resistant organisms in war-associated injuries remains uncertain; possibilities include nosocomial transmission ( 5 ), particularly through prior contact with severely compromised health systems ( 6 ). Another possibility is fecal colonization with extended-spectrum β-lactamase–producing gram-negative bacteria.…”

Identification of small molecules inhibiting diguanylate cyclases to control bacterial biofilm development

“…This pathogen is multi-drug resistant and chronically colonizes tissue wounds as biofilms (Dallo & Weitao 2010; Murphy et al 2011). All four inhibitors of DGC were able to significantly reduce biofilm formation by A. baumannii in the MBEC biofilm formation assay (Figure 3).…”