TABLE I.
Characteristics of Military Personnel Wounded in Afghanistan with Clinical Suspicion of a Wound Infection and Cultures with Positive Microbiologic Findings Collected within 7 Days Post-Injurya
| Characteristics, No. (%) | Patients (N = 316) |
|---|---|
| Male | 315 (99.7) |
| Blast mechanism | 297 (94.0) |
| Injured during | |
| Fall | 85 (26.9) |
| Summer | 119 (37.6) |
| Spring | 71 (22.5) |
| Winter | 41 (13.0) |
| Injury severity scoreb, median (IQR) | 33 (27-43) |
| Days from injury to initial culture, median (IQR) | 3.5 (3-5) |
| Met diagnostic criteria for Wound infections | 198 (62.7) |
| Burn or wound skin and soft-tissue infection | 164 (51.9) |
| Osteomyelitis | 34 (10.8) |
| Culture findingsc | |
| Gram-negative bacilli | 188 (59.5) |
| Gram-positive organisms | 186 (58.9) |
| MDR Gram-negative bacteriad | 69 (21.8) |
| Anaerobes | 41 (12.9) |
| Mixed culture findingse | 156 (49.4) |
IQR: interquartile range; MDR: multidrug-resistant.
Study population is focused on the first week of trauma care following injury, which includes medevac and a 2-3 day stay at Landstuhl Regional Medical Center followed by transition to a U.S. hospital.
See Linn (1995)32 for information on injury severity score.
Includes both colonizing and infection isolates recovered from wound cultures. Colonizing isolates were from wounds with clinical suspicion but did not meet diagnostic criteria for infection.
Multidrug-resistant bacteria primarily included Escherichia coli, Acinetobacter spp., and Enterobacter spp.
Includes a combination of Gram-negative bacilli, Gram-positive organisms, and/or anaerobes.