Evolution of the microbiota of wound infections in military personnel during the full-scale russian invasion: a retrospective cohort study (2022–2024)

Background. Infectious complications remain one of the main causes of mortality and morbidity in blast injury among military personnel. The prevalence of infectious complications in blast injury reaches 35 %, and often the causative agents of such infections are multidrug-resistant microorganisms. T...

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Main Authors: N.A. Beley, O.A. Loskutov, A.M. Strokan, O.B. Izmaylova
Format: Article
Language:English
Published: Zaslavsky O.Yu. 2024-11-01
Series:Медицина неотложных состояний
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Online Access:https://emergency.zaslavsky.com.ua/index.php/journal/article/view/1767
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author N.A. Beley
O.A. Loskutov
A.M. Strokan
O.B. Izmaylova
author_facet N.A. Beley
O.A. Loskutov
A.M. Strokan
O.B. Izmaylova
author_sort N.A. Beley
collection DOAJ
description Background. Infectious complications remain one of the main causes of mortality and morbidity in blast injury among military personnel. The prevalence of infectious complications in blast injury reaches 35 %, and often the causative agents of such infections are multidrug-resistant microorganisms. The purpose was to analyze the dynamics of causative agents of wound infections in military personnel during the full-scale russian invasion. Materials and methods. We conducted a retrospective cohort study of servicemen who were injured during hostilities and were treated at the Feofaniya Clinical Hospital from March 2022 to March 2024. Wound culture was mandatory for study inclusion. Samples were taken from wounds with signs of inflammation, and microbiological testing was carried out in the laboratory of Feofaniya Clinical Hospital. Cultures were conducted in accordance with standard methods of medical microbiology. The disc diffusion method was used to determine the sensitivity of isolates to antimicrobial drugs. Results. The study included 478 servicemen (mean age of 36.60 ± 0.42 years, range 18–67, 99.6 % were males) who have had 1441 wound cultures, and 2483 isolates were identified. No pathogen was detected in 289 cases (11.63 %), fungal isolates were detected in 59 (2.38 %) cases, and the remaining isolates (2135; 85.98 %) were found to be bacterial. Gram-negative flora predominated among them — 80.2 % (95% confidence interval (CI) 78.4–81.8), while Gram-positive flora accounted for 19.8 % (95% CI 18.2–21.6), p < 0.001. The most common pathogens were Klebsiella pneumoniae (22.8 %; 95% CI 21.2–24.5), Acinetobacter baumannii (20 %; 95% CI 18.5–21.6), Pseudomonas aeruginosa (13.6 %; 95% CI 12.3–14.9) and Enterococcus spp. (6.2 %; 95% CI 5.3–7.2). Other pathogens were observed with a proportion of < 5 %. Monomicrobial cultures accounted for 50.5 % (95% CI 47.8–53.3), two isolates were found in 34.0 % (95% CI 31.4–36.6), three isolates — in 12.7 % (95% CI 10.9–14.5), four isolates — in 2.2 % (95% CI 1.4–3.0) and five isolates — in 0.6 % (95% CI 0.3–1.1) of all cultures. There was a significant level of antibiotic resistance — 99.7 % of Klebsiella pneumoniae isolates were multidrug-resistant. Conclusions. Wound infection in blast injury is characterized by a significant predominance of Gram-negative microflora with a high prevalence of antibiotic resistance. Polymicrobial flora was identified in half of the cases of wound infection.
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spelling doaj-art-24aab7efdcf1422e9f0f847a4476ed742025-01-12T11:41:06ZengZaslavsky O.Yu.Медицина неотложных состояний2224-05862307-12302024-11-0120761562110.22141/2224-0586.20.7.2024.17671767Evolution of the microbiota of wound infections in military personnel during the full-scale russian invasion: a retrospective cohort study (2022–2024)N.A. Beley0https://orcid.org/0000-0001-9318-0386O.A. Loskutov1https://orcid.org/0000-0002-7646-9193A.M. Strokan2https://orcid.org/0000-0002-4544-7143O.B. Izmaylova3https://orcid.org/0000-0003-0908-4573Shupyk National Healthcare University of Ukraine, Kyiv, UkraineShupyk National Healthcare University of Ukraine, Kyiv, UkraineShupyk National Healthcare University of Ukraine, Kyiv, Ukraine; Feofaniya Clinical Hospital of the State Management of Affairs, Kyiv, UkraineFeofaniya Clinical Hospital of the State Management of Affairs, Kyiv, UkraineBackground. Infectious complications remain one of the main causes of mortality and morbidity in blast injury among military personnel. The prevalence of infectious complications in blast injury reaches 35 %, and often the causative agents of such infections are multidrug-resistant microorganisms. The purpose was to analyze the dynamics of causative agents of wound infections in military personnel during the full-scale russian invasion. Materials and methods. We conducted a retrospective cohort study of servicemen who were injured during hostilities and were treated at the Feofaniya Clinical Hospital from March 2022 to March 2024. Wound culture was mandatory for study inclusion. Samples were taken from wounds with signs of inflammation, and microbiological testing was carried out in the laboratory of Feofaniya Clinical Hospital. Cultures were conducted in accordance with standard methods of medical microbiology. The disc diffusion method was used to determine the sensitivity of isolates to antimicrobial drugs. Results. The study included 478 servicemen (mean age of 36.60 ± 0.42 years, range 18–67, 99.6 % were males) who have had 1441 wound cultures, and 2483 isolates were identified. No pathogen was detected in 289 cases (11.63 %), fungal isolates were detected in 59 (2.38 %) cases, and the remaining isolates (2135; 85.98 %) were found to be bacterial. Gram-negative flora predominated among them — 80.2 % (95% confidence interval (CI) 78.4–81.8), while Gram-positive flora accounted for 19.8 % (95% CI 18.2–21.6), p < 0.001. The most common pathogens were Klebsiella pneumoniae (22.8 %; 95% CI 21.2–24.5), Acinetobacter baumannii (20 %; 95% CI 18.5–21.6), Pseudomonas aeruginosa (13.6 %; 95% CI 12.3–14.9) and Enterococcus spp. (6.2 %; 95% CI 5.3–7.2). Other pathogens were observed with a proportion of < 5 %. Monomicrobial cultures accounted for 50.5 % (95% CI 47.8–53.3), two isolates were found in 34.0 % (95% CI 31.4–36.6), three isolates — in 12.7 % (95% CI 10.9–14.5), four isolates — in 2.2 % (95% CI 1.4–3.0) and five isolates — in 0.6 % (95% CI 0.3–1.1) of all cultures. There was a significant level of antibiotic resistance — 99.7 % of Klebsiella pneumoniae isolates were multidrug-resistant. Conclusions. Wound infection in blast injury is characterized by a significant predominance of Gram-negative microflora with a high prevalence of antibiotic resistance. Polymicrobial flora was identified in half of the cases of wound infection.https://emergency.zaslavsky.com.ua/index.php/journal/article/view/1767wound infectionblast injuryantibiotic resistancegram-negative bacterial infections
spellingShingle N.A. Beley
O.A. Loskutov
A.M. Strokan
O.B. Izmaylova
Evolution of the microbiota of wound infections in military personnel during the full-scale russian invasion: a retrospective cohort study (2022–2024)
Медицина неотложных состояний
wound infection
blast injury
antibiotic resistance
gram-negative bacterial infections
title Evolution of the microbiota of wound infections in military personnel during the full-scale russian invasion: a retrospective cohort study (2022–2024)
title_full Evolution of the microbiota of wound infections in military personnel during the full-scale russian invasion: a retrospective cohort study (2022–2024)
title_fullStr Evolution of the microbiota of wound infections in military personnel during the full-scale russian invasion: a retrospective cohort study (2022–2024)
title_full_unstemmed Evolution of the microbiota of wound infections in military personnel during the full-scale russian invasion: a retrospective cohort study (2022–2024)
title_short Evolution of the microbiota of wound infections in military personnel during the full-scale russian invasion: a retrospective cohort study (2022–2024)
title_sort evolution of the microbiota of wound infections in military personnel during the full scale russian invasion a retrospective cohort study 2022 2024
topic wound infection
blast injury
antibiotic resistance
gram-negative bacterial infections
url https://emergency.zaslavsky.com.ua/index.php/journal/article/view/1767
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AT oaloskutov evolutionofthemicrobiotaofwoundinfectionsinmilitarypersonnelduringthefullscalerussianinvasionaretrospectivecohortstudy20222024
AT amstrokan evolutionofthemicrobiotaofwoundinfectionsinmilitarypersonnelduringthefullscalerussianinvasionaretrospectivecohortstudy20222024
AT obizmaylova evolutionofthemicrobiotaofwoundinfectionsinmilitarypersonnelduringthefullscalerussianinvasionaretrospectivecohortstudy20222024