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Infectious complications of war-related injuries in children: Experience from the Gaza Conflict

Rachel Herbert1, Mariam Abdelkader2, Khadija Abdelmonem2

  • 1Burjeel Medical City, Abu Dhabi, United Arab Emirates; Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates; College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases
|June 16, 2026
PubMed

Insights

Pediatric war injuries in Gaza involve severe blast trauma and frequent multidrug-resistant (MDR) infections. Effective management requires multidisciplinary care, including infectious disease specialists and robust antimicrobial stewardship.

Area of Science:

  • Orthopedic Surgery
  • Infectious Diseases
  • Pediatric Trauma Care

Background:

  • Conflict zones present unique challenges in pediatric trauma care.
  • High-energy blast injuries are common in war-related trauma.
  • Infections with multidrug-resistant (MDR) organisms complicate these injuries.

Purpose of the Study:

  • To describe injury patterns in children with war-related trauma from Gaza.
  • To analyze microbiology and antimicrobial resistance profiles of infections.
  • To evaluate clinical outcomes in children treated at a tertiary orthopedic center.

Main Methods:

  • Retrospective observational cohort study.
  • Inclusion of children aged 0-18 years treated between November 2023 and November 2024.
  • Collection of demographic, injury, microbiological, antimicrobial, surgical, and outcome data.

Main Results:

  • 89.8% of cases involved blast injuries, with 85.7% having open fractures.
  • 32.7% of children had active infections, often polymicrobial (93.8%) and involving MDR organisms (75%).
  • Pseudomonas aeruginosa (75%) and Enterobacterales (68.8%) were common MDR pathogens; chronic osteomyelitis led to longer hospital stays.

Conclusions:

  • Pediatric war trauma from Gaza is characterized by severe blast injuries and frequent MDR infections.
  • Multidisciplinary orthoplastic and infectious diseases care is crucial.
  • Enhanced MDR screening, microbiology capacity, and antimicrobial stewardship are vital for managing conflict-associated trauma.
Abstract

Keywords:
Antimicrobial resistanceBlast injuriesConflictOsteomyelitisPediatric trauma

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