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Infectious Diseases An Unseen Enemy Soldiers Face From Day One

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DOCTOR SOLDIER
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At this time of year, Canada collectively takes time to remember the sacrifices made by those who have fought to maintain our freedom. These honourable individuals have given everything for us. We, in turn, show our appreciation as well as our hope we never live through the scourge of war again.

While our thoughts may focus on the moments in which soldiers have gone to battle to face a known enemy, we tend to forget another kind of foe facing the troops. This one isn't human, however, it's microbial. Indeed, infectious diseases have claimed millions of lives and at times left those who fight in dire straits.

Times have changed over the years and the likelihood of a microbial casualty is less likely. Yet the military still must deal with infections and find ways to heal soldiers effectively. However, this can be troublesome as many illnesses are not limited to one particular species. Without knowing what causes an infection, achieving resolution is far more complicated.

These soldiers were going to go through a long battle.

A perfect example of this type of unknown is skin infection. It's a common plight in many human population divisions, including the military. Most of the time the culprits are known enemies of the human state, including Staphylococcus aureus, which is common in abscesses, and Pseudomonas aeruginosa, which can infect burns and open wounds. But they are only two of several possible microbial enemy combatants capable of leading to troubles both in the short term, and possibly later on in life.

For an American team of researchers, more needed to be done to better understand the skin infections affecting troops, such as those in training. They wished to learn the names of the hidden enemies causing both abscesses and also cellulitis. Their results revealed the complexity of these conditions and the need to find better treatments.

The team enrolled a total of 241 military trainees over the course of two and a half years. Each individual had a skin infection and was seeking treatment. The wounds were swabbed and then analyzed to identify any bacterial species. In addition, other samples from the individuals were taken including nasal swabs and other areas of the body.

s aureus
Staphylococcus aureus next to white blood cell.

When the results came back, S. aureus was found to be the most prevalent enemy. In abscesses, seven out of every 10 wounds was caused by this bacterium. However, nearly half of these were identified as methicillin-resistant, better known as MRSA. This in itself was a rather unfortunate finding, suggesting these soldiers were going to go through a long battle.

Perhaps more unsettling was the source of the pathogen. In approximately half of the cases, the infection originated from the patient. They had been colonized either in the nose or on the skin, and had spread the bacteria during their strenuous training regimen.

This information was troubling as it revealed a change in the way microbial infection spreads. Usually, the environment or other already-sickened individuals were the most likely source. But this suggested the spread of this bacterium in the community had made these trainees carriers. They not only were a risk to others, but also to themselves.

The result revealed how at times, even the most friendly ally can sometimes end up being a bitter foe.

From the 241 samples collected, 40 went through a second round of testing to identify the microbial population in the wound. In the abscesses, S. aureus was the dominant species but it welcomes several other members of the genus with names such as S. haemolyticus, S. agalactiae, and S. lugdunensis. These species are all genetically related and their presence was not surprising.

As for the cellulitis, there was a wide variety of bacterial species present. The most common also happened to be the most perplexing. It was an environmental species called Rhodanobacter terrae. There had been no known reports of this bacterium causing infection, yet two-thirds of the patients possessed this bacterium in their wounds. This was the first time this harmless species had ever been suspected of causing infection. The result revealed how at times, even the most friendly ally can sometimes end up being a bitter foe.

For the authors, this study offers a glimpse into the reality of military and microbial life. Soldiers need to be keenly aware of the potential for infection even from species not known to cause trouble. More importantly, medical staff needs to be careful not to pre-judge an infection based on prior history. Proper vetting through testing is the only way to be certain of a diagnosis and route to resolution.

The study also highlights the importance of understanding the plight every soldier faces during their time in the ranks. From the moment they enter up until their resignation, they face obstacles and challenges most of us may never see. For that reason, whether microbial or memorial, we should always keep them in our thoughts and thank them for their service.

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