AustralieFrV1, Main, Exploration, bibRecord, 006906

Multidrug-Resistant Chronic Osteomyelitis Complicating War Injury in Iraqi Civilians

Identifieur interne : 006906 ( Main/Exploration ); précédent : 006905; suivant : 006907

Multidrug-Resistant Chronic Osteomyelitis Complicating War Injury in Iraqi Civilians

Auteurs : Richard A. Murphy [États-Unis] ; Jean-Baptiste Ronat [France] ; Rasheed M. Fakhri [Jordanie] ; Patrick Herard [France] ; Nikki Blackwell [Australie] ; Sophie Abgrall [France] ; Deverick J. Anderson [États-Unis]

Source :

The Journal of trauma, injury, infection, and critical care [ 1079-6061 ] ; 2011.

RBID : Pascal:11-0341413

Descripteurs français

Pascal (Inist)
- Résistance multiple, Chronique, Ostéite, Complication, Guerre, Résistance traitement, Irak, Chirurgie, Anesthésie, Traitement.
Wicri :
- topic : Guerre, Chirurgie.

English descriptors

KwdEn :
- Anesthesia, Chronic, Complication, Iraq, Multiple resistance, Osteitis, Surgery, Treatment, Treatment resistance, War.

Abstract

Background: War-related orthopedic injury is frequently complicated by environmental contamination and delays in management, placing victims at increased risk for long-term infectious complications. We describe, among Iraqi civilians with war-related chronic osteomyelitis, the bacteriology of infection at the time of admission. Methods: In the Médecins Sans Frontieres Reconstructive Surgery Project in Amman, Jordan, we retrospectively reviewed baseline demographics and results of initial intraoperative surgical cultures among Iraqi civilians with suspected osteomyelitis. Results: One hundred thirty-seven patients (90% male; median age, 35 years [interquartile range {IQR}, 28-46]; median time since initial injury, 19 months [IQR, 10-35]) were admitted with suspected chronic osteomyelitis after war-related injury. One hundred seven patients had a positive intraoperative culture. Before arrival, patients had undergone a median of 4 (IQR, 2-6) surgical procedures in Iraq. Fifty-nine (55%) of 107 patients with confirmed osteomyelitis had a multidrug-resistant (MDR) organism isolated at admission: cefepime-resistant Enterobacteriaceae (n = 40), methicillin-resistant Staphylococcus aureus (n = 16), and MDR Acinetobacter baumannii (n = 3). An association of borderline significance existed between a history of more than two prior surgical procedures in Iraq and an MDR isolate at program entry (multivariate: odds ratio, 5.3; 95% confidence interval, 0.9-30.6 ; p = 0.064). Conclusion: Health care actors, including Iraqi health facilities and humanitarian medical organizations, must be aware of the link between chronic war injury and antimicrobial drug resistance in this region and should be prepared for the management challenges involved with the treatment of chronic drug-resistant osteomyelitis.

Affiliations:

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Le document en format XML

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<series><title level="j" type="main">The Journal of trauma, injury, infection, and critical care</title>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Anesthesia</term>
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<term>Osteitis</term>
<term>Surgery</term>
<term>Treatment</term>
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<term>Chronique</term>
<term>Ostéite</term>
<term>Complication</term>
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<term>Résistance traitement</term>
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<term>Chirurgie</term>
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<front><div type="abstract" xml:lang="en">Background: War-related orthopedic injury is frequently complicated by environmental contamination and delays in management, placing victims at increased risk for long-term infectious complications. We describe, among Iraqi civilians with war-related chronic osteomyelitis, the bacteriology of infection at the time of admission. Methods: In the Médecins Sans Frontieres Reconstructive Surgery Project in Amman, Jordan, we retrospectively reviewed baseline demographics and results of initial intraoperative surgical cultures among Iraqi civilians with suspected osteomyelitis. Results: One hundred thirty-seven patients (90% male; median age, 35 years [interquartile range {IQR}, 28-46]; median time since initial injury, 19 months [IQR, 10-35]) were admitted with suspected chronic osteomyelitis after war-related injury. One hundred seven patients had a positive intraoperative culture. Before arrival, patients had undergone a median of 4 (IQR, 2-6) surgical procedures in Iraq. Fifty-nine (55%) of 107 patients with confirmed osteomyelitis had a multidrug-resistant (MDR) organism isolated at admission: cefepime-resistant Enterobacteriaceae (n = 40), methicillin-resistant Staphylococcus aureus (n = 16), and MDR Acinetobacter baumannii (n = 3). An association of borderline significance existed between a history of more than two prior surgical procedures in Iraq and an MDR isolate at program entry (multivariate: odds ratio, 5.3; 95% confidence interval, 0.9-30.6 ; p = 0.064). Conclusion: Health care actors, including Iraqi health facilities and humanitarian medical organizations, must be aware of the link between chronic war injury and antimicrobial drug resistance in this region and should be prepared for the management challenges involved with the treatment of chronic drug-resistant osteomyelitis.</div>
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Multidrug-Resistant Chronic Osteomyelitis Complicating War Injury in Iraqi Civilians

Multidrug-Resistant Chronic Osteomyelitis Complicating War Injury in Iraqi Civilians

Source :

Descripteurs français

English descriptors

Abstract

Links toward previous steps (curation, corpus...)

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri