Infection with high proportion of multidrug-resistant bacteria in conflict-related injuries is associated with poor outcomes and excess resource consumption: a cohort study of Syrian patients treated in Jordan.

Abstract:

BACKGROUND:Armed conflicts are a major contributor to injury and death globally. Conflict-related injuries are associated with a high risk of wound infection, but it is unknown to what extent infection directly relates to sustainment of life and restoration of function. The aim of this study was to investigate the outcome and resource consumption among civilians receiving acute surgical treatment due to conflict-related injuries. Patients with and without wound infections were compared. METHODS:We performed a cohort study using routinely collected data from 457 consecutive Syrian civilians that received surgical treatment for acute conflict-related injuries during 2014-2016 at a Jordanian hospital supported by Médecins Sans Frontières. We defined wound infection as clinical signs of infection verified by a positive culture. We used logistic regression models to evaluate infection-related differences in outcome and resource consumption. RESULTS:Wound infection was verified in 49/457 (11%) patients. Multidrug-resistance (MDR) was detected in 36/49 (73%) of patients with infection. Among patients with infection, 11/49 (22%) were amputated, compared to 37/408 (9%) without infection, crude relative risk = 2.62 (95% confidence interval 1.42-4.81). Infected patients needed 12 surgeries on average, compared to five in non-infected patients (p < .00001). Mean length of stay was 77 days for patients with infection, and 35 days for patients without infection (p = .000001). CONCLUSIONS:Among Syrian civilians, infected conflict-related wounds had a high prevalence of MDR bacteria. Wound infection was associated with poor outcomes and high resource consumption. These results could guide the development of antibiotic protocols and adaptations of surgical management to improve care for wound infections in conflict-related injuries. TRIAL REGISTRATION:ClinicalTrials.gov ( NCT02744144 ). Registered April 13, 2016. Retrospectively registered.

journal_name

BMC Infect Dis

journal_title

BMC infectious diseases

authors

Älgå A,Wong S,Shoaib M,Lundgren K,Giske CG,von Schreeb J,Malmstedt J

doi

10.1186/s12879-018-3149-y

subject

Has Abstract

pub_date

2018-05-22 00:00:00

pages

233

issue

1

issn

1471-2334

pii

10.1186/s12879-018-3149-y

journal_volume

18

pub_type

杂志文章
  • Evaluation of tolerability with the co-formulation elvitegravir, cobicistat, emtricitabine, and tenofovir disoproxil fumarate for post-HIV exposure prophylaxis.

    abstract:BACKGROUND:The preferred regimen for HIV post-exposure prophylaxis (PEP) is based mainly on safety and tolerability because it is given to immunocompetent people without HIV infection for a limited time (28 days). The frequency of adverse events (AEs) may be > 60%. Although AEs are generally not severe, they can lead t...

    journal_title:BMC infectious diseases

    pub_type: 杂志文章

    doi:10.1186/s12879-016-2056-3

    authors: Valin N,Fonquernie L,Daguenel A,Campa P,Anthony T,Guiguet M,Girard PM,Meyohas MC

    更新日期:2016-11-29 00:00:00

  • Epidemic of Klebsiella pneumoniae ST11 clone coproducing KPC-2 and 16S rRNA methylase RmtB in a Chinese University Hospital.

    abstract:BACKGROUND:Emergence of rmtB-positive Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae (KPC-KP) poses a great threat to antimicrobial treatment options. METHODS:From January 2010 to December 2010, non-duplicate KPC-KP isolates from our hospital were screened for rmtB and multiple other resistance dete...

    journal_title:BMC infectious diseases

    pub_type: 杂志文章

    doi:10.1186/1471-2334-12-373

    authors: Li JJ,Sheng ZK,Deng M,Bi S,Hu FS,Miao HF,Ji ZK,Sheng JF,Li LJ

    更新日期:2012-12-23 00:00:00

  • A multi-center, open-label trial to compare the efficacy and pharmacokinetics of Artemether-Lumefantrine in children with severe acute malnutrition versus children without severe acute malnutrition: study protocol for the MAL-NUT study.

    abstract:BACKGROUND:Malnutrition and malaria frequently coexist in sub-Saharan African countries. Studies on efficacy of antimalarial treatments usually follow the WHO standardized protocol in which severely malnourished children are systematically excluded. Few studies have assessed the efficacy of chloroquine, sulfadoxine-pyr...

    journal_title:BMC infectious diseases

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1186/s12879-015-0963-3

    authors: Denoeud-Ndam L,Dicko A,Baudin E,Guindo O,Grandesso F,Sagara I,Lasry E,Palma PP,Parra AM,Stepniewska K,Djimde AA,Barnes KI,Doumbo OK,Etard JF

    更新日期:2015-06-12 00:00:00

  • CRYPTOCOCCAL meningitis in a HIV negative newly diagnosed diabetic patient: a CASE report.

    abstract:BACKGROUND:This case report emphasizes the need to recognize cryptococcus as a possible cause of meningitis in non-HIV patients in Sub-Saharan Africa and to highlight the possibility of grave outcomes due to the paradoxical immune response in diabetic patients with cryptococcus meningitis. It also highlights the need f...

    journal_title:BMC infectious diseases

    pub_type: 杂志文章

    doi:10.1186/s12879-018-3625-4

    authors: Owuor OH,Chege P

    更新日期:2019-01-03 00:00:00

  • Unusual presentation of fatal disseminated varicella zoster virus infection in a patient with lupus nephritis: a case report.

    abstract:BACKGROUND:The risk of life-threatening complications, such as visceral disseminated varicella zoster virus (VZV) infection, is greater in immunosuppressed individuals, such as systemic lupus erythematosus (SLE) patients. CASE PRESENTATION:Here, a case is reported of a Caucasian woman diagnosed with lupus nephritis an...

    journal_title:BMC infectious diseases

    pub_type: 杂志文章

    doi:10.1186/s12879-020-05254-6

    authors: Vassia V,Croce A,Ravanini P,Leutner M,Saglietti C,Fangazio S,Quaglia M,Smirne C

    更新日期:2020-07-23 00:00:00

  • Modelling estimates of the burden of Respiratory Syncytial virus infection in adults and the elderly in the United Kingdom.

    abstract:BACKGROUND:Growing evidence suggests respiratory syncytial virus (RSV) is an important cause of respiratory disease in adults. However, the adult burden remains largely uncharacterized as most RSV studies focus on children, and population-based studies with laboratory-confirmation of infection are difficult to implemen...

    journal_title:BMC infectious diseases

    pub_type: 临床试验,杂志文章

    doi:10.1186/s12879-015-1218-z

    authors: Fleming DM,Taylor RJ,Lustig RL,Schuck-Paim C,Haguinet F,Webb DJ,Logie J,Matias G,Taylor S

    更新日期:2015-10-23 00:00:00

  • First multicenter study on multidrug resistant bacteria carriage in Chinese ICUs.

    abstract:BACKGROUND:The importance of multidrug-resistant organisms (MDRO) in Chinese hospitals is not clearly delineated. Thus we sought to assess the prevalence of MDRO in Chinese intensive care units (ICUs). METHODS:Prospective study of inpatients admitted consecutively to eight ICUs in four Chinese cities in 2009-10. Admis...

    journal_title:BMC infectious diseases

    pub_type: 杂志文章,多中心研究

    doi:10.1186/s12879-015-1105-7

    authors: Ma X,Wu Y,Li L,Xu Q,Hu B,Ni Y,Wu A,Sun S,Jarlier V,Robert J

    更新日期:2015-08-21 00:00:00

  • Performance comparison of CareStart™ HRP2/pLDH combo rapid malaria test with light microscopy in north-western Tigray, Ethiopia: a cross-sectional study.

    abstract:BACKGROUND:Rapid diagnostic tests (RDTs) are alternative methods for microscopy in the diagnosis of malaria in resource limited settings. Among commercially available RDTs, CareStart™ Malaria test was found to show reliable results. This study evaluated the performance of CareStart™ Malaria Combo test kit in Northweste...

    journal_title:BMC infectious diseases

    pub_type: 杂志文章

    doi:10.1186/s12879-017-2503-9

    authors: Feleke DG,Tarko S,Hadush H

    更新日期:2017-06-06 00:00:00

  • Epidemiology, species distribution and outcome of nosocomial Candida spp. bloodstream infection in Shanghai.

    abstract:BACKGROUND:Yeasts, mostly Candida, are important causes of bloodstream infections (BSI), responsible for significant mortality and morbidity among hospitalized patients. The epidemiology and species distribution vary from different regions. The goals of this study were to report the current epidemiology of Candida BSI ...

    journal_title:BMC infectious diseases

    pub_type: 杂志文章

    doi:10.1186/1471-2334-14-241

    authors: Yang ZT,Wu L,Liu XY,Zhou M,Li J,Wu JY,Cai Y,Mao EQ,Chen EZ,Lortholary O

    更新日期:2014-05-06 00:00:00

  • Implications of COVID-19 in high burden countries for HIV/TB: A systematic review of evidence.

    abstract:BACKGROUND:The triple burden of COVID-19, tuberculosis and human immunodeficiency virus is one of the major global health challenges of the twenty-first century. In high burden HIV/TB countries, the spread of COVID-19 among people living with HIV is a well-founded concern. A thorough understanding of HIV/TB and COVID-1...

    journal_title:BMC infectious diseases

    pub_type: 杂志文章

    doi:10.1186/s12879-020-05450-4

    authors: Tamuzi JL,Ayele BT,Shumba CS,Adetokunboh OO,Uwimana-Nicol J,Haile ZT,Inugu J,Nyasulu PS

    更新日期:2020-10-09 00:00:00

  • Determination of clinical and demographic predictors of laboratory-confirmed influenza with subtype analysis.

    abstract:BACKGROUND:Rapid influenza diagnosis is important for early identification of outbreaks, effective management of high-risk contacts, appropriate antiviral use, decreased inappropriate antibiotic use and avoidance of unnecessary laboratory testing. Given the inconsistent performance of many rapid influenza tests, clinic...

    journal_title:BMC infectious diseases

    pub_type: 杂志文章

    doi:10.1186/1471-2334-12-129

    authors: Woolpert T,Brodine S,Lemus H,Waalen J,Blair P,Faix D

    更新日期:2012-06-07 00:00:00

  • Molecular characteristics and clinical features of pediatric methicillin-susceptible Staphylococcus aureus infection in a medical center in northern Taiwan.

    abstract:BACKGROUND:There have been no reports regarding clinical features and molecular characteristics of childhood methicillin-susceptible Staphylococcus aureus (MSSA) infections in Taiwan. METHODS:We prospectively collected clinical S. aureus isolates from patients aged < 18 years in a university-affiliated hospital in 201...

    journal_title:BMC infectious diseases

    pub_type: 杂志文章

    doi:10.1186/s12879-019-4033-0

    authors: Chen YJ,Chen PA,Chen CJ,Huang YC

    更新日期:2019-05-10 00:00:00

  • Prevalence of group B streptococcus among pregnant women and newborns at Hawassa University comprehensive specialized hospital, Hawassa, Ethiopia.

    abstract:BACKGROUND:Group B streptococcus (GBS) is reported as the leading cause of neonatal sepsis and meningitis. Newborns from GBS colonized pregnant women are at high risk of infection. METHOD:A Hospital based cross-sectional study was conducted at Hawassa University Comprehensive Specialized Hospital from November 05, 201...

    journal_title:BMC infectious diseases

    pub_type: 杂志文章

    doi:10.1186/s12879-019-3859-9

    authors: Ali MM,Woldeamanuel Y,Woldetsadik DA,Chaka TE,Fenta DA,Dinberu MT,Weldetensaye EK,Ismael SJ,Tadesse BT

    更新日期:2019-04-16 00:00:00

  • Time trend of clinical cases of Lyme disease in two hospitals in Belgium, 2000-2013.

    abstract:BACKGROUND:As several studies indicated an increase in Lyme disease (LD), notably in neighbouring countries, concerns have arisen regarding the evolution of Lyme disease in Belgium. In order to confirm or infirm the increase of LD in Belgium, we focused on hospital admissions of patients diagnosed with LD between 2000 ...

    journal_title:BMC infectious diseases

    pub_type: 杂志文章

    doi:10.1186/s12879-017-2841-7

    authors: De Keukeleire M,Vanwambeke SO,Kabamba B,Belkhir L,Pierre P,Luyasu V,Robert A

    更新日期:2017-12-05 00:00:00

  • Estimating the nationwide transmission risk of measles in US schools and impacts of vaccination and supplemental infection control strategies.

    abstract:BACKGROUND:The spread of airborne infectious diseases such as measles is a critical public health concern. The U.S. was certified measles-free in 2000, but the number of measles cases has increased in recent years breaking the record of the nationwide annual number of cases since 1992. Although the characteristics of s...

    journal_title:BMC infectious diseases

    pub_type: 杂志文章

    doi:10.1186/s12879-020-05200-6

    authors: Azimi P,Keshavarz Z,Cedeno Laurent JG,Allen JG

    更新日期:2020-07-11 00:00:00

  • The role of TLR2 in the host response to pneumococcal pneumonia in absence of the spleen.

    abstract:BACKGROUND:Asplenic individuals are susceptible for overwhelming infection with Streptococcus pneumoniae, carrying a high mortality. Although Toll-like receptor (TLR)-2 is considered the major receptor for Gram-positive bacteria in innate immunity, it does not play a major role in host defense against pneumococcal pneu...

    journal_title:BMC infectious diseases

    pub_type: 杂志文章

    doi:10.1186/1471-2334-12-139

    authors: Lammers AJ,de Porto AP,de Boer OJ,Florquin S,van der Poll T

    更新日期:2012-06-21 00:00:00

  • Fatigue during treatment for hepatitis C virus: results of self-reported fatigue severity in two Phase IIb studies of simeprevir treatment in patients with hepatitis C virus genotype 1 infection.

    abstract:BACKGROUND:Fatigue is a common symptom of chronic hepatitis C virus (HCV) infection and a frequent side-effect of peginterferon/ribavirin (PR) therapy for HCV. This study evaluated the impact of adding the oral HCV NS3/4A protease inhibitor simeprevir to PR on patient-reported fatigue and health status among patients w...

    journal_title:BMC infectious diseases

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/1471-2334-14-465

    authors: Scott J,Rosa K,Fu M,Cerri K,Peeters M,Beumont M,Zeuzem S,Evon DM,Gilles L

    更新日期:2014-08-26 00:00:00

  • Host biomarkers distinguish dengue from leptospirosis in Colombia: a case-control study.

    abstract:BACKGROUND:Dengue fever and leptospirosis have partially overlapping geographic distributions, similar clinical presentations and potentially life-threatening complications but require different treatments. Distinguishing between these cosmopolitan emerging pathogens represents a diagnostic dilemma of global importance...

    journal_title:BMC infectious diseases

    pub_type: 杂志文章

    doi:10.1186/1471-2334-14-35

    authors: Conroy AL,Gélvez M,Hawkes M,Rajwans N,Liles WC,Villar-Centeno LA,Kain KC

    更新日期:2014-01-20 00:00:00

  • Incidence and predictors of regimen-modification from first-line antiretroviral therapy in Thailand: a cohort study.

    abstract:BACKGROUND:Antiretroviral therapy markedly reduced mortality in HIV-infected individuals. However, in the previous studies, up to 50% of patients are compelled to modify their regimen in middle and low-income countries where salvage drug is still limited. This cohort study aimed to investigate the incidence and predict...

    journal_title:BMC infectious diseases

    pub_type: 杂志文章

    doi:10.1186/s12879-014-0565-5

    authors: Tsuchiya N,Pathipvanich P,Wichukchinda N,Rojanawiwat A,Auwanit W,Ariyoshi K,Sawanpanyalert P

    更新日期:2014-10-30 00:00:00

  • Prevalence of intestinal parasitic infections and associated risk factors among students at Dona Berber primary school, Bahir Dar, Ethiopia.

    abstract:BACKGROUND:Intestinal parasitic infections are still one of the major health concerns in developing countries. Monitoring of intestinal parasitic infection and associated risk factors are essential for intervention strategies. Therefore, the aim of this study was to assess the prevalence of intestinal parasitic infecti...

    journal_title:BMC infectious diseases

    pub_type: 杂志文章

    doi:10.1186/s12879-017-2466-x

    authors: Hailegebriel T

    更新日期:2017-05-23 00:00:00

  • Predictors of indoor absolute humidity and estimated effects on influenza virus survival in grade schools.

    abstract:BACKGROUND:Low absolute humidity (AH) has been associated with increased influenza virus survival and transmissibility and the onset of seasonal influenza outbreaks. Humidification of indoor environments may mitigate viral transmission and may be an important control strategy, particularly in schools where viral transm...

    journal_title:BMC infectious diseases

    pub_type: 杂志文章

    doi:10.1186/1471-2334-13-71

    authors: Koep TH,Enders FT,Pierret C,Ekker SC,Krageschmidt D,Neff KL,Lipsitch M,Shaman J,Huskins WC

    更新日期:2013-02-05 00:00:00

  • ELISA is superior to bacterial culture and agglutination test in the diagnosis of brucellosis in an endemic area in China.

    abstract:BACKGROUND:Brucellosis is endemic in many areas in China. The current diagnosis of Brucellosis predominantly relies on the traditional bacterial culture and serum agglutination test. In this study, we aimed to explore the value of ELISA in the diagnosis of Brucellosis in Chinese population. METHODS:We recruited 235 pa...

    journal_title:BMC infectious diseases

    pub_type: 杂志文章

    doi:10.1186/s12879-019-4729-1

    authors: Xu N,Wang W,Chen F,Li W,Wang G

    更新日期:2020-01-06 00:00:00

  • Association of Escherichia coli O157:H7 tir polymorphisms with human infection.

    abstract:BACKGROUND:Emerging molecular, animal model and epidemiologic evidence suggests that Shiga-toxigenic Escherichia coli O157:H7 (STEC O157) isolates vary in their capacity to cause human infection and disease. The translocated intimin receptor (tir) and intimin (eae) are virulence factors and bacterial receptor-ligand pr...

    journal_title:BMC infectious diseases

    pub_type: 杂志文章

    doi:10.1186/1471-2334-7-98

    authors: Bono JL,Keen JE,Clawson ML,Durso LM,Heaton MP,Laegreid WW

    更新日期:2007-08-24 00:00:00

  • The impact of voluntary counselling and testing services on sexual behaviour change and HIV incidence: observations from a cohort study in rural Tanzania.

    abstract:BACKGROUND:It is widely assumed that voluntary counselling and testing (VCT) services contribute to HIV prevention by motivating clients to reduce sexual risk-taking. However, findings from sub-Saharan Africa have been mixed, particularly among HIV-negative persons. We explored associations between VCT use and changes ...

    journal_title:BMC infectious diseases

    pub_type: 杂志文章

    doi:10.1186/1471-2334-14-159

    authors: Cawley C,Wringe A,Slaymaker E,Todd J,Michael D,Kumugola Y,Urassa M,Zaba B

    更新日期:2014-03-22 00:00:00

  • Towards accurate exclusion of neonatal bacterial meningitis: a feasibility study of a novel 16S rDNA PCR assay.

    abstract:BACKGROUND:PCRctic is an innovative assay based on 16S rDNA PCR technology that has been designed to detect a single intact bacterium in a specimen of cerebro-spinal fluid (CSF). The assay's potential for accurate, fast and inexpensive discrimination of bacteria-free CSF makes it an ideal adjunct for confident exclusio...

    journal_title:BMC infectious diseases

    pub_type: 杂志文章

    doi:10.1186/s12879-020-05160-x

    authors: Abelian A,Mund T,Curran MD,Savill SA,Mitra N,Charan C,Ogilvy-Stuart AL,Pelham HRB,Dear PH

    更新日期:2020-06-22 00:00:00

  • Analysis of Bordetella pertussis pertactin and pertussis toxin types from Queensland, Australia, 1999-2003.

    abstract:BACKGROUND:In Australia two acellular Bordetella pertussis vaccines have replaced the use of a whole cell vaccine. Both of the licensed acellular vaccines contain the following three components; pertussis toxoid, pertussis filamentous haemagglutinin and the 69 kDa pertactin adhesin. One vaccine also contains pertussis ...

    journal_title:BMC infectious diseases

    pub_type: 杂志文章

    doi:10.1186/1471-2334-6-53

    authors: Byrne S,Slack AT

    更新日期:2006-03-16 00:00:00

  • Declining tuberculosis prevalence in Saharia, a particularly vulnerable tribal community in Central India: evidences for action.

    abstract:BACKGROUND:In spite of an alarmingly high tuberculosis (TB) burden amongst the Saharia tribe of central India, there is hardly any study to investigate the impact of DOTS implementation on the magnitude of tuberculosis disease and the changes over time. This article present the findings of TB prevalence surveys conduct...

    journal_title:BMC infectious diseases

    pub_type: 杂志文章

    doi:10.1186/s12879-019-3815-8

    authors: Rao VG,Bhat J,Yadav R,Sharma RK,Muniyandi M

    更新日期:2019-02-20 00:00:00

  • Human adenovirus type 7 infection causes a more severe disease than type 3.

    abstract:BACKGROUND:Human adenovirus type 3 (HAdV-3) and 7 (HAdV-7) cause significant morbidity and develop severe complications and long-term pulmonary sequelae in children. However, epidemiologic reports have suggested that nearly all highly severe or fatal adenoviral diseases in children are associated with HAdV-7 rather tha...

    journal_title:BMC infectious diseases

    pub_type: 杂志文章

    doi:10.1186/s12879-018-3651-2

    authors: Fu Y,Tang Z,Ye Z,Mo S,Tian X,Ni K,Ren L,Liu E,Zang N

    更新日期:2019-01-09 00:00:00

  • The influence of diabetes mellitus on the spectrum of uropathogens and the antimicrobial resistance in elderly adult patients with urinary tract infection.

    abstract:BACKGROUND:The role of Diabetes mellitus (DM) in the etiology and in the antimicrobial resistance of uropathogens in patients with urinary tract infection has not been well clarified. For this reason we have evaluated the spectrum of uropathogens and the profile of antibiotic resistance in both diabetic and non diabeti...

    journal_title:BMC infectious diseases

    pub_type: 杂志文章

    doi:10.1186/1471-2334-6-54

    authors: Bonadio M,Costarelli S,Morelli G,Tartaglia T

    更新日期:2006-03-17 00:00:00

  • Knowledge, attitudes and behaviour of hospital health-care workers regarding influenza A/H1N1: a cross sectional survey.

    abstract:BACKGROUND:To assess the knowledge, the attitudes, and the behaviour towards influenza A/H1N1 and the vaccination among health-care workers (HCWs). METHODS:A sample of HCWs was selected from a random sample of non-teaching public hospitals, located in the cities of Naples and Avellino (Italy), received a self-administ...

    journal_title:BMC infectious diseases

    pub_type: 杂志文章

    doi:10.1186/1471-2334-14-208

    authors: Albano L,Matuozzo A,Marinelli P,Di Giuseppe G

    更新日期:2014-04-16 00:00:00