The spectrum of pathogens in combat wounds of the limbs: own results and retrospective analysis

Background. Infectious complications arising from combat wounds are one of the most serious problems in military medicine. Their microbiological monitoring is a necessary foundation for choosing the initial antimicrobial treatment, predictive risk stratification, optimization of surgical tactics, and implementation of local patient management protocols.

The aim of the study — to explore the species composition of wound infection pathogens in combat injuries of the limbs based on the results of microbiological testing conducted in a hospital functioning during a military conflict.

Methods. We performed a retrospective analysis of microbiological data from 249 patients with combat wounds admitted to the hospital between July 2023 and March 2025. Microorganisms were identified using MALDI-TOF mass spectrometry.

Results. Among the 383 isolates, Staphylococcus aureus dominated (30.03%), followed by Acinetobacter baumannii and Pseudomonas aeruginosa (8.62% each). S. aureus occurred significantly more often than A. baumannii and P. aeruginosa combined. We identified 59 unique pathogens, including 13.31% relatively rare pathogens. Polymicrobial associations were found in 37.34% of patients. The proportion of Gram-positive microflora (55.1%) significantly predominated over Gram-negative microflora (43.1%).

Conclusions. The obtained data confirm the statistically significant dominance of S. aureus in the structure of pathogens in infected gunshot wounds. The high frequency of polymicrobial associations and the presence of rare pathogens necessitate the use of modern diagnostic methods, combined antimicrobial therapy, and an individualized treatment approach.