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Analysis of wound infections among pediatric patients following the 2023 Türkiye-Syria earthquakes
Edanur Yeşil1, Özlem Tezol2, Nahida Gokay3
1Department of Pediatrics, Division of Pediatric Infectious Disease, Mersin University Medical Faculty Hospital, Ciftlikkoy, 33120, Mersin, Türkiye. eda_hacettepe@hotmail.com.
Insights
Pediatric wound infection (WI) after the 2023 Turkey-Syria earthquakes was linked to severe injuries and prolonged rubble entrapment. Gram-negative pathogens, often multidrug-resistant, were common, suggesting early broad-spectrum antibiotics are crucial.
Area of Science:
- Disaster medicine
- Pediatric infectious diseases
- Trauma surgery
Background:
- The 2023 Turkey-Syria earthquakes caused widespread devastation, leading to numerous trauma injuries.
- Assessing wound infection (WI) risk factors and microbiology in pediatric earthquake survivors is critical for effective management.
Purpose of the Study:
- To investigate predisposing factors for wound infection (WI) in pediatric patients following earthquake-related injuries.
- To characterize the microbiological profile of wounds in this cohort.
Main Methods:
- A descriptive study was conducted on 180 pediatric patients injured in the earthquakes.
- Clinical and laboratory parameters associated with WI development were analyzed.
Main Results:
- Wound infection (WI) occurred in 12.2% of patients, with higher incidence in those trapped under rubble and experiencing severe trauma (e.g., crush syndrome, multiple extremity injuries).
- Blood product transfusion was significantly associated with WI development (OR=9.878).
- Gram-negative pathogens (81%) predominated, with high rates of multidrug and extensively drug resistance (75%).
Conclusions:
- Severe trauma and prolonged entrapment are significant risk factors for WI in pediatric earthquake survivors.
- Early empirical broad-spectrum antibiotic therapy, considering local resistance patterns, is recommended to prevent morbidity.
Purpose:
On February 6, 2023, two earthquakes of magnitude 7.7 and 7.6 occurred consecutively in Turkey and Syria. This study aimed to investigate the predisposing factors for wound infection (WI) and the microbiological characteristics of wounds after earthquake-related injuries.
Methods:
This descriptive study evaluated pediatric patients' frequency of WI, and the clinical and laboratory parameters associated with the development of WI were investigated.
Results:
The study included 180 patients (91 female). The mean age of the patients was 123.9 ± 64.9 months and 81.7% (n = 147) of them had been trapped under rubble. Antibiotic treatment to prevent WI had been administered to 58.8% (n = 106) of all patients. WI was observed in 12.2% (n = 22) of the cases. In patients who developed WI, the incidence of exposure to a collapse, crush syndrome, compartment syndrome, multiple extremity injury, fasciotomy, amputation, peripheral nerve injury, thoracic compression, blood product use, intubation, and the use of central venous catheters, urinary catheters, and thoracic tubes were more frequent (p < 0.05). The need for blood product transfusion was associated with the development of WI (OR = 9.878 [95% CI: 2.504-38.960], p = 0.001). The negative predictive values of not developing WI at values of white blood cell count of < 11,630/mm3, creatine kinase < 810 U/L, potassium < 4.1 mEq/L, ALT < 29 U/L, AST < 32 U/L, and CRP < 45.8 mg/L were 93.7%, 96.8%, 90.8%, 93.3%, 100%, and 93.5%, respectively. Gram-negative pathogens (81%) were detected most frequently in cases of WI. Seventy-five percent of patients were multidrug- and extensively drug-resistant.
Conclusion:
This study leans empirical approach of our disaster circumstances. In cases with risk factors predisposing to the development of WI, it may be rational to start broad-spectrum antibiotics while considering the causative microorganisms and resistance profile to prevent morbidity.
