Infections after musculoskeletal injuries in earthquake survivors

Imran Hasanoglu; Bircan Kayaaslan; Guzelali Ozdemir; Baris Guntekin; Ceyhun Caglar; Muge Ayhan; Atahan Durgal; Fatma Eser; Ayse Kaya Kalem; Rahmet Guner

doi:10.52312/jdrs.2024.1517

Imran Hasanoglu¹, Bircan Kayaaslan¹, Guzelali Ozdemir², Baris Guntekin¹, Ceyhun Caglar², Muge Ayhan¹, Atahan Durgal², Fatma Eser¹, Ayse Kaya Kalem¹, Rahmet Guner¹

¹Department of Infectious Diseases and Clinical Microbiology, Ankara Bilkent City Hospital, Ankara, Türkiye
²Department of Orthopedics and Traumatology, Ankara Bilkent City Hospital, Ankara, Türkiye

Keywords: Earthquake, infection, musculoskeletal injuries.

Abstract

Objectives: This study aimed to investigate the infections following musculoskeletal injuries in earthquake survivors, offering a future clinical point of reference for the handling of musculoskeletal injuries resulting from earthquakes.

Patients and methods: In this single-center retrospective observational study, 225 earthquake survivors (120 females, 105 males; median: 39 years; range, 18 to 94 years) admitted between February 2023 and April 2023 were evaluated. Patients with musculoskeletal injuries and patients who had at least one month of follow-up data were included in the study. Diagnosis of healthcare-associated infections was verified by an infection control physician in accordance with the Centers for Disease Control and Prevention.

Results: Among all cultures, the most isolated pathogen was Acinetobacter baumannii (49.4%), followed by enterococci (28.6%). Colistin sensitivity of A. baumannii was 36 (94.7%). However, sensitivity rate was 5.3% for ciprofloxacin, 10.5% for piperacillin-tazobactam, and 26.4% for carbapenems, which are frequently used for skin and soft tissue infections. Among all, 76% of the microorganisms isolated from wound culture and 58% of the microorganisms isolated from deep tissue culture were found to be multidrug-resistant pathogens. During the follow-up, 12 (5.3%) patients had hospital-acquired urinary tract infections, 13 (5.7%) patients had hospitalacquired bloodstream infections, one (0.4%) patient had hospital-acquired pneumonia, and 74 (32.8%) patients had surgical site infections. Eighty (35.6%) of the patients were followed up in the intensive care unit, and the overall mortality rate was 2.7%.

Conclusion: While gram-positive microorganisms are frequently the causative microorganisms in infections after traumatic injuries, this study revealed that gram-negative microorganisms could be observed more frequently in postearthquake traumatic injuries. Most causative microorganisms are resistant to commonly prescribed antibiotics in clinical settings, which makes them more challenging to treat.

Citation: Hasanoglu I, Kayaaslan B, Ozdemir G, Guntekin B, Caglar C, Ayhan M, et al. Infections after musculoskeletal injuries in earthquake survivors. Jt Dis Relat Surg 2024;35(3):684-691. doi: 10.52312/jdrs.2024.1517.

Ethics Committee Approval

The study protocol was approved by the Ankara City Hospital Clinical Research Ethics Committee (date: 22.03.2023, no: E1-23-3384). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Informed Consent

A written informed consent was obtained from the patients.

Author Contributions

Conceptualization and methodology, formal analysis: I.H., B.K., G.O.; Data collection: B.G., A.D., M.A., A.K.K., F.E.; Writing draft: I.H.; Review & editing: I.H., B.K., G.O., B.G., A.D., M.A., A.K.K., F.E., R.G.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.