Microbiology of combat-related extremity wounds: Trauma Infectious Disease Outcomes Study

Katrin Mende*, Laveta Stewart, Faraz Shaikh, William Bradley, Dan Lu, Margot R. Krauss, Lauren Greenberg, Qilu Yu, Dana M. Blyth, Timothy J. Whitman, Joseph L. Petfield, David R. Tribble

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


We present extremity wound microbiology data from 250 combat casualties (2009–2012). Confirmed extremity wound infections (EWIs)were based on clinical and laboratory findings. Suspected EWIs had isolation of organisms from wound cultures with associated signs/symptoms not meeting clinical diagnostic criteria. Colonized wounds had organisms isolated without any infection suspicion. A total of 335 confirmed EWIs (131 monomicrobial and 204 polymicrobial)were assessed. Gram-negative bacteria were predominant (57% and 86% of monomicrobial and polymicrobial infections, respectively). In polymicrobial infections, 61% grew only bacteria, while 30% isolated bacteria and mold. Multidrug resistance was observed in 32% of isolates from first monomicrobial EWIs ±3 days of diagnosis, while it was 44% of isolates from polymicrobial EWIs. Approximately 96% and 52% of the suspected and colonized wounds, respectively, shared ≥1 organism in common with the confirmed EWI on the same patient. Understanding of combat-related EWIs can lead to improvements in combat casualty care.

Original languageEnglish
Pages (from-to)173-179
Number of pages7
JournalDiagnostic Microbiology and Infectious Disease
Issue number2
StatePublished - Jun 2019


  • Extremity infections
  • Extremity wounds
  • Open fractures
  • Trauma-related infections
  • Wound microbiology


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