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120 YEARS OF ADVANCES FOR MILITARY AND PUBLIC HEALTH
It’s not in our main mission, but if a hospital asks us for help, we give it. “Our research priorities are to expedite bioinformatic capabilities so we can annotate whole genomes. Current characterization methods are insufficient, but looking at the whole genome of an organism creates an extremely large data set and complex analysis. You want to detect these superbug and other genes quickly and cheaply, but how you read the spread of a growing line of bacteria is subjective. I would say the lack of available diagnostic methods for these organizations drove the need here.”
VETERINARY SERVICES
The Veterinary Services Program ensures that research complies with the Association for Assessment and Accreditation of Laboratory Animal Care International. Photo by Frank Miller
MRSN was the first to detect the presence of superbug genes, which Lesho said typically come from host-nation patients. When a sample arrives from doctors in another country, MRSN confirms what it is and is not, then alerts the reporting facility and sends a report to policymakers, starting with the Army Surgeon General, who create and enforce policy. “If you have two patients with the same infection – one identified from blood, the other from urine – the question is which patient gave it to the other. Or is it genetically unrelated? We impact empiric therapy when a clinician is faced with a positive culture but doesn’t have all the details yet. When a patient comes in, the doctor wants to start treatment right away, but it will take awhile to get test results,” he said.
“It’s not uncommon for the reporting group to believe they do not have a resistant organism when they do. After that, they go through a hierarchy of characterizations, based on what it is. If it is from theater or a deadly outbreak, we can move on it quickly, determine what it is resistant to in antibiotics, what it’s related to.” MRSN also translates basic research into clinical usefulness. “For example, one hospital had an outbreak resistant to every antibiotic we had, so we used state-of-the-art research methods to determine the mechanism and now have a simple test hospitals can use to test for that bacteria. That also is true of the superbug genes,” Lesho said. “Our big focus is on health care-associated infections, which may change from month to month.
The institute conducts research in areas that might, at first glance, seem unusual for an organization dedicated to the health of deployed U.S. warfighters. One of those is the Veterinary Services Program, headed by Lt. Col. Kenneth E. Despain. “Our mission, within the larger WRAIR mission, is to provide relevant, professional, and world-class veterinary support that allows the WRAIR and Naval Medical Research Center investigators success in developing and sustaining medical capabilities for the warfighter,” he explained. “We’ve had Veterinary Services almost from the start of WRAIR, although we were realigned in 2011, taking our existing veterinary pathology and lab animal medicine programs and merging them into one. “We provide oversight to the animal care and use programs and make sure we comply with the Association for Assessment and Accreditation of Laboratory Animal Care International. We take care of rats, mice, monkeys, any kind of research animal, providing housing, environmental enrichment, and husbandry. We consult with researchers on model use and development. For example, in most research, investigators are trying to mimic the human condition which, in many species, closely resembles humans.” The vision for Veterinary Services is to maintain excellence in management and operations of research in WRAIR’s vivarium, where animals are housed and cared for, and support labs for antemortem and postmortem procedures.