Caracterización de las infecciones de herida entre pacientes procedentes de la guerra ruso-ucraniana en un hospital Role 4

IF 2.6 4区医学 Q3 INFECTIOUS DISEASES Enfermedades infecciosas y microbiologia clinica Pub Date : 2024-11-01 DOI:10.1016/j.eimc.2024.04.004

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Abstract

Introduction

The management of infections in war wounds is a problem aggravated by the presence of multiresistant bacteria and requires a combined approach with surgery. Literature has identified the risks and patterns of antibiotic resistance in previous armed conflicts, but the Russian-Ukrainian conflict has required the study of specific bacterial resistance patterns.

Methods

We included war-injured patients from the Russian-Ukrainian conflict transferred for treatment to the General Defense Hospital of Zaragoza from May 2022 to October 2023. Epidemiological data, factors related to the injury, presence of infection and microbiological results were collected. These data were subsequently analyzed statistically.

Results

Fifty-three patients were included in the study, with a mean age of 35.6 years; 83% were injured by an explosive mechanism and all received antibiotic therapy prior to transfer. Seventeen patients had skin, soft tissue or joint infection. Correlation was demonstrated with the presence of bone lesion (P = .03), skin coverage defect (P = .000) and presence of foreign bodies (P = .006). Nine patients had monomicrobial cultures, and the most frequently isolated microorganisms were Gram negative bacilli (GNB) and Staphylococcus aureus. Virtually all GNB presented some resistance mechanism.

Conclusion

Our work shows the correlation of war wound infection with the presence of foreign bodies and affected tissues. Likewise, the presence of polymicrobial wounds is emphasized, with a predominance of GNB and multidrug-resistant S. aureus.

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一家医院的俄乌战争伤员伤口感染特征 Role 4

导言：由于存在多重耐药细菌，战伤感染的治疗问题更加严重，需要与外科手术相结合。文献已确定了以往武装冲突中抗生素耐药性的风险和模式，但俄乌冲突需要研究特定细菌的耐药性模式。我们收集了流行病学数据、受伤相关因素、感染情况和微生物学结果。结果研究共纳入 53 名患者，平均年龄为 35.6 岁；83% 的患者因爆炸装置受伤，所有患者在转院前均接受了抗生素治疗。17名患者有皮肤、软组织或关节感染。感染与骨损伤（P = 0.03）、皮肤覆盖缺损（P = 0.000）和异物（P = 0.006）存在相关性。九名患者进行了单菌培养，最常分离出的微生物是革兰氏阴性杆菌（GNB）和金黄色葡萄球菌。我们的研究表明，战伤感染与异物和受影响组织的存在有关。同样，我们还强调了伤口多微生物的存在，其中主要是革兰氏阴性杆菌和耐多药的金黄色葡萄球菌。

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来源期刊

Enfermedades infecciosas y microbiologia clinica 医学-传染病学

CiteScore

2.10

自引率

8.00%

发文量

194

审稿时长

29 days

期刊介绍： Hoy está universalmente reconocida la renovada y creciente importancia de la patología infecciosa: aparición de nuevos agentes patógenos, de cepas resistentes, de procesos con expresión clínica hasta ahora desconocida, de cuadros de una gran complejidad. Paralelamente, la Microbiología y la Infectología Clínicas han experimentado un gran desarrollo como respuesta al reto planteado por la actual patología infecciosa. Enfermedades Infecciosas y Microbiología Clínica es la Publicación Oficial de la Sociedad Española SEIMC. Cumple con la garantía científica de esta Sociedad, la doble función de difundir trabajos de investigación, tanto clínicos como microbiológicos, referidos a la patología infecciosa, y contribuye a la formación continuada de los interesados en aquella patología mediante artículos orientados a ese fin y elaborados por autores de la mayor calificación invitados por la revista.