Evaluation of Wound Infections after the 2023 Kahramanmaraş Earthquakes
Melike Törüyenler-Coşkunpınar1, Ezgi Gülten1, İrem Akdemir1
1Department of Infectious Diseases and Clinical Microbiology, Ankara University School of Medicine, Ankara, Türkiye.
Objective:
Wound infections represent a major concern among earthquake survivors, particularly in patients requiring emergency surgical interventions. Multidrug-resistant (MDR) bacteria have increasingly been reported as dominant pathogens in post-earthquake infections. This study aimed to evaluate the clinical and microbiological characteristics of trauma-related wound infections following the 2023 Kahramanmaraş earthquakes and to assess empirical antimicrobial treatment strategies.
Materials And Methods:
This retrospective observational study included adult patients with post-earthquake wound infections who were admitted to Ankara University Faculty of Medicine Hospitals. Demographic, clinical, and microbiological data were analyzed, and factors associated with MDR infections were statistically evaluated.
Results:
The study included 47 patients. The median duration of entrapment under debris was 18 hours (range, 0.5-120 hours), and 74.5% of patients had crush syndrome. Among the 41 patients (87.2%) referred from external centers, 51.2% had received prior antibiotic therapy. Multidrug-resistant (MDR) microorganisms were detected in 57.4% of cases. Acinetobacter baumannii was the most frequently isolated pathogen, accounting for 53.6% of all isolates. The presence of MDR infection was significantly associated with referral from an external center (p=0.002), a history of fasciotomy and/or amputation (p=0.001), and longer duration of entrapment under debris (p=0.019). Admission to the intensive care unit (ICU) was required for 63.8% of patients. The mean ICU length of stay was 8.16 (±9.23) days, and ICU hospitalization was significantly longer among patients with MDR infections (p=0.036). Empirical antimicrobial therapy was modified in 72.3% of cases based on culture results. The 28-day and 90-day survival rates were 100% and 95.7%, respectively.
Conclusion:
Multidrug-resistant Gram-negative bacteria, particularly A. baumannii, predominate in post-earthquake wound infections. Empirical antimicrobial strategies should account for healthcare-associated pathogens, and early infection control interventions are essential to optimize patient outcomes.
Insights
Multidrug-resistant bacteria, especially Acinetobacter baumannii, are common in earthquake wound infections. Effective empirical antimicrobial treatment requires considering healthcare-associated pathogens and implementing early infection control.
Area of Science:
- Trauma and Orthopedic Surgery
- Infectious Diseases
- Public Health
Background:
- Wound infections are a significant threat to survivors of natural disasters, especially those needing surgery.
- Multidrug-resistant (MDR) bacteria are increasingly identified as primary causes of infections following earthquakes.
Purpose of the Study:
- To investigate the clinical and microbiological features of trauma-related wound infections after the 2023 Kahramanmaraş earthquakes.
- To evaluate the effectiveness of empirical antimicrobial treatment strategies for these infections.
Main Methods:
- A retrospective observational study was conducted on adult patients with post-earthquake wound infections.
- Demographic, clinical, and microbiological data were collected and analyzed.
- Statistical analysis was performed to identify factors associated with MDR infections.
Main Results:
- Of 47 patients, 57.4% had MDR infections, with Acinetobacter baumannii being the most common pathogen (53.6%).
- MDR infection was linked to external referral, fasciotomy/amputation history, and longer entrapment duration.
- Patients with MDR infections had significantly longer ICU stays.
Conclusions:
- MDR Gram-negative bacteria, particularly A. baumannii, are prevalent in post-earthquake wound infections.
- Empirical antimicrobial therapies must consider healthcare-associated pathogens.
- Early infection control measures are crucial for improving patient outcomes.
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