Biofilms and Persistent Wound Infections in United States Military Trauma Patients: a Case-control Analysis
ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX
Pagination or Media Count:
Background Complex traumatic injuries sustained by military personnel, particularly when involving extremities, often result in infectious complications and substantial morbidity. One factor that may further impair patient recovery is the persistence of infections. Surface-attached microbial communities, known as biofilms, may play a role in hindering the management of infections however, clinical data associating biofilm formation with persistent or chronic infections are lacking. Therefore, we evaluated the production of bacterial biofilms as a potential risk factor for persistent infections among wounded military personnel. Methods Bacterial isolates and clinical data from military personnel with deployment-related injuries were collected through the Trauma Infectious Disease Outcomes Study. The study population consisted of patients with diagnosed skin and soft-tissue infections. Cases wounds with bacterial isolates of the same organism collected 14 days apart were compared to controls wounds with non-recurrent bacterial isolates, which were matched by organism and infectious disease syndrome. Potential risk factors for persistent infections, including biofilm formation, were examined in a univariate analysis. Data are expressed as odds ratios OR 95 confidence interval CI. Results On a per infected wound basis, 35 cases representing 25 patients and 69 controls representing 60 patients were identified. Eight patients with multiple wounds were utilized as both cases and controls. Overall, 235 bacterial isolates were tested for biofilm formation in the case control analysis. Biofilm formation was significantly associated with infection persistence OR 29.49 CI 6.24-infinity in a univariate analysis.
- Anatomy and Physiology
- Medicine and Medical Research