The characteristics of infections in crush syndrome

Clin Microbiol Infect. 2002 Apr;8(4):202-6. doi: 10.1046/j.1469-0691.2002.00371.x.


Objective: To analyze the results of clinical and bacteriological examinations of crush syndrome patients admitted to our institute after the Marmara earthquake.

Methods: Data were collected retrospectively from patients' files. Forty patients are included. Their mean age was 31.5 +/- 13.5 years and 18 were male. Their mean time under the rubble was 13.1 +/- 14.4 h. Fasciotomies were performed on 41 extremities of 30 patients. One hundred and twelve (mean 2.9 +/- 1.9 samples/patient) bacteriological samples were collected from wounds (51), blood (23), urine (25) and catheters (13).

Results: Microbial growth was detected in 67 samples from 38 (95%) patients. Non-fermenting Gram-negative bacilli, Gram-positive cocci, Enterobacteriaciace and yeast-like fungi were isolated in 67%, 17%, 12% and 4% of the samples, respectively. Acinetobacter (36%) and Pseudomonas aeruginosa (21%), the major bacterial isolates from wound infections, were resistant to carbapenems and sensitive to quinolones. As the hospitalization period increased, other infections supervened. Gram-positive cocci and non-fermenting Gram-negative bacilli were detected in six blood and seven catheter samples and methicillin-resistant Staphylococcus aureus was the major isolate. Nine (22%) of the patients died due to sepsis despite all supportive therapies.

Conclusions: Infections are still major factors in crush syndrome-related deaths.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Crush Syndrome / complications*
  • Crush Syndrome / microbiology*
  • Disasters
  • Drug Resistance, Bacterial
  • Female
  • Gram-Negative Bacterial Infections / complications*
  • Gram-Negative Bacterial Infections / microbiology
  • Gram-Positive Bacterial Infections / complications*
  • Gram-Positive Bacterial Infections / microbiology
  • Humans
  • Male
  • Middle Aged
  • Mycoses / complications*
  • Sepsis / complications
  • Sepsis / microbiology
  • Sepsis / mortality
  • Turkey