industry, congressional staff, retired flag officers, and

and Development Agreement with Focus Technologies,

scientists from CDC and NIH.  Challenges to imple 

Inc., a company that has developed and manages an

menting improvements in civilian and military STD

internationally respected network for antibiotic resist 

control programs were identified and discussed, along

ance surveillance, The Surveillance Network

with the role of cost effective screening and the need

(TSN

).  During FY 2001 two key medical centers

for managed care priorities to be sensitive to public

were enrolled in the TSN network, Tripler Army

health priorities such as the conduct of cultures for

Medical Center and Wilford Hall Air Force Medical

antibiotic resistance.  Other needs included communi 

Center.  Daily downloads of antibiotic resistance

cating in a clear and concise way to legislators and civic

patterns from routine microbiology lab cultures were

leaders the nature and scope of this hidden problem. To

arranged.  Arrangements have been made to have

further promote solutions within DoD to the problem

Keesler Air Force Medical Center join the network in

of STD prevention and control, DoD GEIS provided

2002.  Once five DoD sites are fully operational, a

FY 2001 funding for the U.S. Army Center for Health

DoD network will be formed and a centralized DoD

Promotion and Preventive Medicine (USACHPPM) to

antibiotic resistance information sharing mechanism

sponsor a tri service meeting to explore the concept

established.  Participation in the TSN system facili 

of a DoD STD Control Office at USACHPPM.  This

tates daily, independent quality assurance review and

office would serve as the dedicated staff of the STDPC

feedback to microbiology labs, the continuous updating

to provide evidence based epidemiologic support, help

of antibiograms, the comparison of one institution's

operationalize related policies, and share best practices.

experience with that of other similar military and

The meeting will take place during early FY 2002.

civilian institutions, and access to data for MHS wide

and local policy making purposes. 

One aspect of STD prevention and control needing

additional focus has been surveillance for antibiotic 

During FY 2001 the U.S. Government published part 1

resistant gonococci.  While the DoD generally follows

of the Federal Inter Agency Antibiotic Resistance Task

CDC guidelines for the management of STDs, those

Force Action Plan.  Part 1 focuses on delineating priori 

guidelines are not necessarily ideal for places where

ties for improving surveillance, prevention and control,

drug resistance patterns differ from what is the current

product development, and research as they relate to

pattern on the U.S. mainland.  DoD GEIS has con 

antibiotic resistance within the U.S.  Part 2 will focus

tinued this year to support the participation of Fort

on international initiatives that the government wishes

Bragg, NC, and Tripler Army Medical Center, HI, in

to promote.  The DoD has been an active contributor to

the CDC Gonococcal Isolate Surveillance Program

this consensus process since, as the manager of one of

(GISP).  Additional DoD sites have been identified

the two large federal health care systems, it should

for enrollment, including a site in Korea. 

serve as a model for non federal entities trying to

respond to Federal Task Force objectives.  DoD GEIS

For resistance of other organisms and to move the

has been tracking DoD antibiotic resistance initiatives

DoD forward on using automated laboratory based

such as work of the DoD Pharmacoeconomic Center in

surveillance as a key public health methodology,

preparation for the first Task Force progress report that

DoD GEIS has entered into a Cooperative Research

will be published in 2002.

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