Spectrum of infections in physiotherapy and rehabilitation ward for war victims and veterans from Iraq and Syria (short note)

Abstract

Spectrum of infectious diseases in Physiotherapy and Rehabilitation Ward of Military Hospital in Iraq sponsored by the German Armed Forces is analyzed. In contrast to usual bacterial flora in non-war zones gram negative bacteria from external sources during blast injuries were found, including Acinetobacter baumanii, Pseudomonas putida, Enterobacteriaceae and Flavobacteria.

Headnote

Key words:

War victims, Infection, Rehabilitation, Iraq, Veterans.

Abstract:

Spectrum of infectious diseases in Physiotherapy and Rehabilitation Ward of Military Hospital in Iraq sponsored by the German Armed Forces is analyzed. In contrast to usual bacterial flora in non-war zones gram negative bacteria from external sources during blast injuries were found, including Acinetobacter baumanii, Pseudomonas putida, Enterobacteriaceae and Flavobacteria.

Introduction

Rehabilitation and physiotherapy wards for either civilian or veterans are integral parts of all field and military hospitals since war in Afghanistan in 2001and after that in all conflicts in Middle East (Iraq 2003, Lybia 2009, Syria 2011). (1-5) The aim of this study was to compare etiology of infections in patients recovering in this kind of wards for limb injuries or prosthesis after war related injuries in 2016-2017. (6-10) Other aim was to assess the proportion of MRSA versus other organisms among isolates in 2016-2017 in a Greek clinic for war victims from Syria and Iraq.

Patients and methods

In total, 197 patients were admitted for rehabilitation with new prosthesis received from international humanitarian organisations in 2016 in a Greek Military Facility in UNHCR camp Veria, Greece. Type of patient, injury and etiology of infection was recorded. Medical data were then compared and analysed. Among other data, sociodemographic data on post-war victims were collected as well.

Results and discussion

Majority of patients (167 out of 197) were victims of war injury - traumatic amputation of leg or arm with prosthesis replacement. Infections were mainly due to postoperative complications (wounds). Out of 167 traumatic limb amputations were 37 upper limb and 130 lower limb. Other 20 amputations were caused by infected burns or other causes (9). One patient was lost to follow-up. Post-operative wound infection was present in 130 cases, other 11 patients already came with infected injury. Skin and soft tissue infection not related to operation was present in 51 cases. Healthcare infrastructure after exodus in 2015/2016 in all Balkan countries is not sufficient to cover medical and social pathology (1-5). MRSA is usually referred as a commonest pathogen, following by non-fermenting GNB (6-10).

Conclusions

Spectrum and etiology of inections in patients with war related traumatic injuries is different than in patients from EU. Instead of MRSA and S.pyogenes, Gram-negative bacteria, such as Pseudomonas species, Acinetobacter and Enterobacteriaceae are prevalent. Low prevalence of MRSA could be explained by extraordinary and different causes of injuries (post-war trauma and physiotherapy) in contrast to non-war related injuries (car accidents, sports, incidental injuries).

Sidebar

E-mail address:

[email protected]

Reprint address:

Michal Olah

St. Elisabeth University of Health and Social Sciences

Nam. 1. Maja 1

Bratislava, Slovakia

Reviewers:

Johnson Nzau Mavole

Catholic university of Eastern Africa, Nairobi, Kenya

Vitalis Okoth Odero

Catholic university of Eastern Africa, Nairobi, Kenya

Publisher:

International Society of Applied Preventive Medicine i-gap

Conflict of interest:

The authors whose names are listed in the title of the article certify that they have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers' bureaus; membership, employment, consultancies, or other equity interest), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

References

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