Evidence map›Paper›PMID 37948254›Full record

ArticleMilitary medicine2023

Seasonality of Microbiology of Combat-Related Wounds and Wound Infections in Afghanistan.

Matthew A Soderstrom, Dana M Blyth, M Leigh Carson, Wesley R Campbell, Joseph M Yabes, Faraz Shaikh, Laveta Stewart, David R Tribble, Clinton K Murray, John L Kiley

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PubMed Full text at PMC Publisher
In one paragraph

Article in Military medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Matthew A SoderstromInfectious Disease Service, Brooke Army Medical Center, Joint Base San Antonio, Fort Sam Houston, TX 78234, USA.
Dana M BlythInfectious Disease Service, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA.
M Leigh CarsonInfectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.
Wesley R CampbellInfectious Disease Service, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA.
Joseph M YabesInfectious Disease Service, Brooke Army Medical Center, Joint Base San Antonio, Fort Sam Houston, TX 78234, USA.
Faraz ShaikhInfectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.
Laveta StewartInfectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.
David R TribbleInfectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.
Clinton K MurrayInfectious Disease Service, Brooke Army Medical Center, Joint Base San Antonio, Fort Sam Houston, TX 78234, USA.
John L KileyInfectious Disease Service, Brooke Army Medical Center, Joint Base San Antonio, Fort Sam Houston, TX 78234, USA.

Funding

DATA CENTER FOR EPIDEMIOLOGIC INVESTIGATIONS OF HIVN01AI005072 · NIAID · NEW ENGLAND RESEARCH INSTITUTES, INC. · PI MCKINLAY, SONJA M · 1990 to 1994
–
NIAID NIH HHS Y01 AI005072
6 · The paper itself

Abstract

introductionBattlefield-related wound infections are a significant source of morbidity among combat casualties. Seasonality of these infections was demonstrated in previous conflicts (e.g., Korea) but has not been described with trauma-related health care-associated infections from the war in Afghanistan.

methodsThe study population included military personnel wounded in Afghanistan (2009-2014) medevac'd to Landstuhl Regional Medical Center and transitioned to participating military hospitals in the United States with clinical suspicion of wound infections and wound cultures collected ≤7 days post-injury. Analysis was limited to the first wound culture from individuals. Infecting isolates were collected from skin and soft-tissue infections, osteomyelitis, and burn soft-tissue infections. Data were analyzed by season (winter [ December 1-February 28/29], spring [March 1-May 31], summer [June 1-August 31], and fall [September 1-November 30]).

resultsAmong 316 patients, 297 (94.0%) sustained blast injuries with a median injury severity score and days from injury to initial culture of 33 and 3.5, respectively. Although all patients had a clinical suspicion of a wound infection, a diagnosis was confirmed in 198 (63%) patients. Gram-negative bacilli (59.5% of 316) were more commonly isolated from wound cultures in summer (68.1%) and fall (67.1%) versus winter (43.9%) and spring (45.1%; P < .001). Multidrug-resistant (MDR) Gram-negative bacilli (21.8%) were more common in summer (21.8%) and fall (30.6%) versus winter (7.3%) and spring (19.7%; P = .028). Findings were similar for infecting Gram-negative bacilli (72.7% of 198)-summer (79.5%) and fall (83.6%; P = .001)-and infecting MDR Gram-negative bacilli (27.3% of 198)-summer (25.6%) and fall (41.8%; P = .015). Infecting anaerobes were more common in winter (40%) compared to fall (11%; P = .036). Gram-positive organisms were not significantly different by season.

conclusionGram-negative bacilli, including infecting MDR Gram-negative bacilli, were more commonly recovered in summer/fall months from service members injured in Afghanistan. This may have implications for empiric antibiotic coverage during these months.

Indexed as

Military PersonnelSoft Tissue InfectionsWound InfectionWounds and InjuriesAfghanistanAntibiotic ProphylaxisGram-Negative BacteriaHumansUnited States

Identifiers

PMID37948254
PMCPMC10637295

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.