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February 21, 1972

Septic Complications of War Wounds

Author Affiliations

From the US Naval Medical Research Unit-2 Detachment, Naval Support Activity Hospital, Da Nang, Republic of Vietnam. Dr. Tong is now with Los-Angeles County/University of Southern California Medical Center, Los Angeles.

JAMA. 1972;219(8):1044-1047. doi:10.1001/jama.1972.03190340050011

Wound and blood cultures were obtained from 30 US marines with severe combat-inflicted extremity injuries. On admission to the hospital, the predominant organisms isolated from the wounds were gram-negative bacteria belonging to the Enterobacter and Mimeae groups, Escherichia coli, and Klebsiella. By the fifth hospital day, a significant increase in the number of wounds yielding Pseudomonas and Proteus organisms was noted. Twelve of 30 patients developed positive blood cultures. Enterobacter and Mimeae were most frequently cultured from the bloodstream. In eight instances, the same strain of gram-negative bacteria was isolated from the wounds and blood. Three patients died in gram-negative septicemia. Recommendations for initial antibiotic therapy in severely wounded patients in a combat area are presented.