ArticleBMC infectious diseases2019
Post-traumatic osteomyelitis in Middle East war-wounded civilians: resistance to first-line antibiotics in selected bacteria over the decade 2006-2016.
Article in BMC infectious diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 53 citations in OpenAlex.
- Conflict-associated wounds and burns infected with GLASS pathogens in the Eastern Mediterranean Region: A systematic review.BMC infectious diseases · 2025Pooled it
- Osteomyelitis.Nature reviews. Disease primers · 2026Review
- Understanding Osteomyelitis in Saudi Arabia's Adult Population: A Nationwide Cross-Sectional Study of Knowledge and Attitudes.International journal of general medicine · 2026Article
- Macrophage-derived amphiregulin induces myofibroblast transition in adipogenic lineage precursors near Staphylococcus aureus abscess in bone marrow.Nature communications · 2025Article
- Antimicrobial susceptibility patterns of bacteria isolated from wound infections in Al-Bayda Governorate -Yemen.BMC infectious diseases · 2025Article
- Antibiotic resistance in the Middle East and Southern Asia: a systematic review and meta-analysis.JAC-antimicrobial resistance · 2025Review
- Healthcare workers' perceptions of postoperative care and implementation challenges in conflict-affected northwest Syria: a mixed-methods analysis.BMJ public health · 2025Article
- Article
- PosttraumaticOpen forum infectious diseases · 2024Article
- Antibiotic susceptibility patterns at the Médecins Sans Frontières (MSF) Acute Trauma Hospital in Aden, Yemen: a retrospective study from January 2018 to June 2021.JAC-antimicrobial resistance · 2024Article
- Anti-Microorganisms · 2023Review
- Promising applications of D-amino acids in periprosthetic joint infection.Bone research · 2023Review
- The In Vivo and In Vitro Assessment of Pyocins in TreatingAntibiotics (Basel, Switzerland) · 2022Review
- Staphylococcus aureus and Acinetobacter baumannii Inhibit Osseointegration of Orthopedic Implants.Infection and immunity · 2022Article
- Antibiotic resistance among bacteria isolated from war-wounded patients at the Weapon Traumatology Training Center of the International Committee of the Red Cross from 2016 to 2019: a secondary analysis of WHONET surveillance data.BMC infectious diseases · 2022Article
- Assessment of antibiotic storage practices, knowledge, and awareness related to antibiotic uses and antibiotic resistance among household members in post-conflict areas of Pakistan: Bi-central study.Frontiers in medicine · 2022Article
- Progress in diagnosis and treatment of post-traumatic osteomyelitis.Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2021Article
- How COVID-19 highlighted the need for infection prevention and control measures to become central to the global conversation: experience from the conflict settings of the Middle East.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2021Article
- Epidemiology and microbiology of fracture-related infection: a multicenter study in Northeast China.Journal of orthopaedic surgery and research · 2021Article
- Antibiotic-ResistantAntibiotics (Basel, Switzerland) · 2021Review
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWar-wounded civilians in Middle East countries are at risk of post-traumatic osteomyelitis (PTO). We aimed to describe and compare the bacterial etiology and proportion of first-line antibiotics resistant bacteria (FLAR) among PTO cases in civilians from Syria, Iraq and Yemen admitted to the reconstructive surgical program of Médecins Sans Frontières (MSF) in Amman, Jordan, and to identify risk factors for developing PTO with FLAR bacteria.
methodsWe retrospectively analyzed the laboratory database of the MSF program. Inclusion criteria were: patients from Iraq, Yemen or Syria, admitted to the Amman MSF program between October 2006 and December 2016, with at least one bone biopsy sample culture result. Only bone samples taken during first orthopedic surgery were included in the analysis. To assess factors associated with FLAR infection, logistic regression was used to estimate odds ratio (ORs) and 95% confidence intervals (CI).
results558 (76.7%) among 727 patients included had ≥1 positive culture results. 318 were from Iraq, 140 from Syria and 100 from Yemen. Median time since injury was 19 months [IQR 8-40]. Among the 732 different bacterial isolates, we identified 228 Enterobacteriaceae (31.5%), 193 Staphylococcus aureus (26.3%), 99 Pseudomonas aeruginosa (13.5%), and 21 Acinetobacter baumanii (2.8%). Three hundred and sixty four isolates were FLAR: 86.2% of Enterobacteriaceae, 53.4% of Pseudomonas aeruginosa, 60.5% of S. aureus and 45% of Acinetobacter baumannii. There was no difference in bacterial etiology or proportion of FLAR according to the country of origin. In multivariate analysis, a FLAR infection was associated with an infection of the lower extremity, with a time since the injury ≤12 months compared with time > 30 months and with more than 3 previous surgeries.
conclusionsEnterobacteriaceae were frequently involved in PTO in war wounded civilians from Iraq, Yemen and Syria between 2006 and 2016. Proportion of FLAR was high, particularly among Enterobacteriaceae, regardless of country of origin.
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