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Early Microbiological Patterns in Combat-Related Extremity Wounds During the Gaza Conflict: A Retrospective Cohort
Ilan Tzaytlin1,2, Yuval Arnon2, Bryan Itkowitz2
1Orthopedic Department, Soroka Medical Center, Yitzhack I. Rager Blvd 151, Be'er Sheva, 8457108, Israel.
Military Medicine
|July 30, 2026
Summary
Early combat wound infections in Gaza were polymicrobial, with both Gram-positive and Gram-negative bacteria. This study provides initial microbiology data from a rapid-evacuation military trauma system.
Area of Science:
- Military medicine
- Infectious disease
- Trauma surgery
Background:
- Combat extremity injuries involve significant soft-tissue damage and contamination.
- Early wound microbiology in conflicts is geographically variable.
- Limited contemporary data exists for the Gaza conflict.
Purpose of the Study:
- To characterize early microbiological findings in combat-related extremity wounds.
- To determine pathogen distribution in operatively managed wounds.
- To provide current data on wound infections in a specific conflict zone.
Main Methods:
- Retrospective, descriptive study at a Level I trauma center.
- Inclusion criteria: bacterial or fungal organism isolated from deep operative culture within 5 days of admission.
- Analysis of 14 patients with 39 microbiological isolates.
Main Results:
- Early culture-positive infection rate was 1.8% for combat casualties and 4.0% for orthopedic trauma patients.
- 78.6% of infections were polymicrobial.
- Common pathogens included Enterococcus faecium, Bacillus cereus, and Escherichia coli; multidrug-resistant organisms found in 28.6%.
Conclusions:
- Early combat wounds show diverse, polymicrobial infections with balanced Gram-positive and Gram-negative proportions.
- Findings offer contemporary insights but require cautious interpretation due to cohort size and sampling methods.
- Further multicenter studies are needed to link early isolates to clinical outcomes.
