The military gear microbiome: risk factors surrounding the warfighter

Car Reen Kok, Zakariae Bram, James B. Thissen, Timothy S. Horseman, Keith S.K. Fong, Susan A. Reichert-Scrivner, Carmen Paguirigan, Kelsey O'Connor, Kristina Thompson, Alexander E. Scheiber, Shalini Mabery, Viseth Ngauy, Catherine F. Uyehara, Nicholas A. Be*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Combat extremity wounds are highly susceptible to contamination from surrounding environmental material. This bioburden could be partially transferred from materials in immediate proximity to the wound, including fragments of the uniform and gear. However, the assessment of the microbial bioburden present on military gear during operational conditions of deployment or training is relatively unexplored. Opportunistic pathogens that can survive on gear represent risk factors for infection following injury, especially following combat blasts, where fibers and other materials are embedded in wounded tissue. We utilized 16S rRNA sequencing to assess the microbiome composition of different military gear types (boot, trouser, coat, and canteen) from two operational environments (training in Hawai’i and deployed in Indonesia) across time (days 0 and 14). We found that microbiome diversity, stability, and composition were dependent on gear type, training location, and sampling timepoint. At day 14, species diversity was significantly higher in Hawai’i samples compared to Indonesia samples for boot, coat, and trouser swabs. In addition, we observed the presence of potential microbial risk factors, as opportunistic pathogenic species, such as Acinetobacter, Pseudomonas, and Staphylococcus, were found to be present in all sample types and in both study sites. These study outcomes will be used to guide the design of antimicrobial materials and uniforms and for infection control efforts following combat blasts and other injuries, thereby improving treatment guidance during military training and deployment. IMPORTANCE Combat extremity wounds are vulnerable to contamination from environments of proximity to the warfighter, leading to potential detrimental outcomes such as infection and delayed wound healing. Therefore, microbial surveillance of such environments is necessary to aid the advancement of military safety and preparedness through clinical diagnostics, treatment protocols, and uniform material design.

Original languageEnglish
JournalApplied and Environmental Microbiology
Issue number1
StatePublished - Jan 2024
Externally publishedYes


  • combat injury
  • gear microbiome
  • microbial genomics
  • military medicine


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