Servicio de Medicina Interna, Hospital Genera4l de la Defensa, Zaragoza, Spain.
Servicio de Cirugía Plástica, Hospital Universitario Miguel Servet, Zaragoza, Spain.
Enferm Infecc Microbiol Clin (Engl Ed). 2024 Nov;42(9):501-506. doi: 10.1016/j.eimce.2024.06.002. Epub 2024 Jun 19.
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.
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.
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 0.03), skin coverage defect (p 0.000) and presence of foreign bodies (p 0.006). 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.
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.
战争创伤感染的处理是一个问题，由于存在多耐药菌而变得更加复杂，需要手术等综合治疗方法。文献已经确定了以前武装冲突中抗生素耐药的风险和模式，但俄罗斯-乌克兰冲突需要研究特定的细菌耐药模式。
我们纳入了自 2022 年 5 月至 2023 年 10 月期间因战争创伤从俄罗斯-乌克兰冲突地区转至萨拉戈萨总医院接受治疗的患者。收集了流行病学数据、与损伤相关的因素、感染情况和微生物学结果；随后对这些数据进行了统计学分析。
本研究共纳入 53 例患者，平均年龄为 35.6 岁；83%的患者因爆炸机制受伤，所有患者在转院前均接受了抗生素治疗。17 例患者有皮肤、软组织或关节感染。研究表明，骨损伤（p 0.03）、皮肤覆盖缺陷（p 0.000）和异物存在（p 0.006）与感染的存在相关。9 例患者进行了单微生物培养，最常分离到的微生物为革兰氏阴性杆菌（GNB）和金黄色葡萄球菌。几乎所有 GNB 都表现出某种耐药机制。
我们的工作表明，战争创伤感染与异物和受损组织的存在相关。此外，还强调了多微生物伤口的存在，以 GNB 和耐多药金黄色葡萄球菌为主。
