title: Microbiology and risk factors associated with war-related wound infections in the Middle East.
abstract: The Middle East region is plagued with repeated armed conflicts that affect both civilians and soldiers. Injuries sustained during war are common and frequently associated with multiple life-threatening complications. Wound infections are major consequences of these war injuries. The microbiology of war-related wound infections is variable with predominance of Gram-negative bacteria in later stages. The emergence of antimicrobial resistance among isolates affecting war-related wound injuries is a serious problem with major regional and global implications. Factors responsible for the increase in multidrug-resistant pathogens include timing and type of surgical management, wide use of antimicrobial drugs, and the presence of metallic or organic fragments in the wound. Nosocomial transmission is the most important factor in the spread of multidrug-resistant pathogens. Wound management of war-related injuries merits a multidisciplinary approach. This review aims to describe the microbiology of war-related wound infections and factors affecting their incidence from conflict areas in Iraq, Syria, Israel, and Lebanon.
authors.affiliation: School of Medicine,American University of Beirut,Beirut,Lebanon.
authors.forename: Z T
authors.initials: ZT
authors.lastname: Sahli
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine,American University of Beirut Medical Centre,Beirut,Lebanon.
authors.forename: A R
authors.initials: AR
authors.lastname: Bizri
authors.affiliation: Department of Surgery,Division of Plastic,Reconstructive and Aesthetic Surgery,American University of Beirut Medical Centre Beirut,Lebanon.
authors.forename: G S
authors.initials: GS
authors.lastname: Abu-Sittah
mesh_terms: D006801:Humans; D007493:Iraq / Q000453:epidemiology; D007557:Israel / Q000453:epidemiology; D007861:Lebanon / Q000453:epidemiology; D012307:Risk Factors; D013593:Syria / Q000453:epidemiology; D014857:Warfare; D014946:Wound Infection / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control / Q000628:therapy
keywords: Middle East; microbiology; multidrug resistance; wound