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Treating post-trauma osteomyelitis cases in the conflict setting of Gaza: a retrospective cohort study | Conference Material / Abstract | MSF Science Portal
Conference Material
|Abstract

Treating post-trauma osteomyelitis cases in the conflict setting of Gaza: a retrospective cohort study

Aqel R
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Abstract
BACKGROUND
Post-traumatic osteomyelitis (PTO) is a serious consequence of orthopaedic trauma often complicated with multi-drug resistant (MDR) infections, a major health issue globally and particularly in conflict settings like Gaza, Palestine. In this study we aimed to provide a description of the clinical characteristics and outcomes of PTO patients treated by MSF in our reconstructive surgery centres in Gaza, Palestine.

METHODS
This is a retrospective cohort study using routinely collected clinical data on patients with PTO admitted to the reconstructive surgery centres supported by MSF in Gaza, between 01-December-2018 and 15-September-2021 and followed up till 31-January-2022.

RESULTS
202 patients with 275 PTO episodes, primarily to gunshot wounds resulting from the conflict in Gaza were included. Among all episodes, 43% (118/275) were polymicrobial, with 437 organisms isolated in total. The most common isolated pathogens were Staphylococcus aureus (157/437, 36%), Staphylococcus epidermidis (71/437, 16%) and Pseudomonas aeruginosa (45/437, 10%). 33% (146/437) of the isolates were MDR; the most prevalent being Methicillin-resistant Staphylococcus aureus [MRSA, (97/146, 66%)] and extended spectrum beta-lactamase [ESBL, (24/146, 16%]. 77 (38%) of PTO patients had >=1 recurrent infection during their follow-up. The odds of developing an MDR infection with a polymicrobial episode were almost twice higher than with a monomicrobial episode [OR 2.39 (95% CI 1.36 - 4.24), p-value=0.03]. Patients admitted within 1 year from their injury were almost 80% less likely to develop an MDR infection versus those admitted >=4 years from their injury [OR 0.17 (95% CI (0.03 - 0.73), p-value=0.031].

CONCLUSION
The study results highlighted the level of complexity of PTO cases seen in Gaza with a high risk of recurrent infections. This provides an evidence-based data to guide the existing MSF treatment guidelines.

KEY MESSAGE
Treating post-traumatic osteomyelitis cases in Gaza is complex and is presented with high MDR infections and risk of recurrent infections.

This abstract is not to be quoted for publication.

Countries

Palestine

Subject Area

antibiotic resistancesurgery & trauma careantimicrobial resistance

Languages

English
Published Date
01 Jun 2022
Conference
Epicentre Scientific Day Paris 2022