Risk Identification and Mitigation of Skin and Soft Tissue Infections in Military Training Environments.

Objective: Staphylococcus aureus (SA), including methicillin-resistant strains (MRSAs), is a major cause of skin and soft tissue infections (SSTIs) in military populations. This study investigated SSTI incidence and SA carriage in a military training site over 16 weeks using a prospective observational cohort design.

Methods: Two training cohorts provided pre- and post-training self-collected swabs for bacterial carriage, and environmental swabs from accommodations, personal items, and training facilities. Hygiene awareness and practices were assessed through questionnaires. Bacteria were identified using culture, mass spectrometry (MALDI-TOF), and genomic sequencing.

Results: Nasal carriage of SA increased from 19% to 49% by the end of training. SSTIs requiring treatment occurred in 16% of participants. Steam cleaning reduced but did not eliminate SA on personal bed linen. Additionally, 40% of participants had poor knowledge of antibacterial cleaning practices and wound management.

Conclusions: Increased SA carriage was linked to human-to-human transmission in close-quarter military training environments.

Implications for public health: Improved personal hygiene training, wound management education, and monitored cleaning protocols are essential to mitigate SSTI risks in communal military training environments.