Enterobacter cancerogenus in Trauma

Abstract

Brief Reports should be submitted online to www.editorialmanager.com/ amsurg. (See details online under ''Instructions for Authors''.) They should be no more than 4 double-spaced pages with no Abstract or sub-headings, with a maximum of four (4) references. If figures are included, they should be limited to two (2). The cost of printing color figures is the responsibility of the author.In general, authors of case reports should use the Brief Report format. This study was approved by the Institutional Review Board of Via Christi Hospitals and the Human Subjects Committee of the University of Kansas School of Medicine-Wichita. A retrospective review of the trauma registry at our American College of Surgeons-verified Level I trauma center between January 1, 2000, and December 31, 2008, was conducted. The trauma registry was queried for all patients injured as a result of PWC use in either Kansas or Oklahoma. Patient demographics, location of accident (lake or river), mechanism of accident, type and use of safety equipment, mechanism of injury, indication of intoxication, neurologic status, radiological studies, need for surgery, intensive care unit (ICU) admission and length of stay, need for mechanical ventilation, ventilator days, hospital length of stay (LOS), and discharge status (home, rehabilitation, or death) were recorded. Data were summarized initially. Comparisons of continuous and ordinal data were conducted using one-way analysis of variance and the Mann-Whitney U test, respectively. Where heterogeneity of variance was identified, the Mann-Whitney U test was used.Twenty-four patients met inclusion criteria. Average patient age was 29.8 ± 14.2 years (range, 5 to 50 years) and patients were predominantly male (n 4 16 [66.7%]). Average population Injury Severity Score (ISS) was 6.0 ± 5.5 (n 4 18; range, 1 to 20). A low percentage of patients (n 4 4 [16.7%]) demonstrated positive toxicology including two results for alcohol, one for opioids, and one for cannabinoids. Seven patients (29.2%) were not tested as a result of low clinical suspicion and included two patients under the age of 15 years. The majority of patients were not wearing safety equipment (62.5%) and no patients were known to be wearing protective head

Trauma Wound Related Infection Caused by <i>Enterobacter cancerogenus</i> and <i>Aeromonas hydrophilia</i>

“…E. cancerogenus is rarely recognized, but it is associated with human infections. Approximately 1 % of Enterobacter infections are due to E. cancerogenus ( 4 ), and these infections seem to occur mostly in the setting of contaminated wounds, as in the present case. A previous case series from the United States showed 59 percent of all published cases of E. cancerogenus have been secondary to trauma, and the mortality rate was 11% ( 4 ).…”

“…Approximately 1 % of Enterobacter infections are due to E. cancerogenus ( 4 ), and these infections seem to occur mostly in the setting of contaminated wounds, as in the present case. A previous case series from the United States showed 59 percent of all published cases of E. cancerogenus have been secondary to trauma, and the mortality rate was 11% ( 4 ). It is possible that the actual mortality rate caused by E. cancerogenus infection is lower because the mortality rate may be more closely related to the trauma itself rather than to the resulting E. cancerogenus infection.…”

“…Enterobacter cancerogenus , previously known as Enterobacter taylorae , is a facultative anaerobic gram-negative bacteria, which can be isolated from the environment ( 1 ). Although this organism can cause bone and joint infections after environmental exposure, such as either a crash injury or laceration, human infections caused by E. cancerogenus are rare ( 2 - 4 ). No cases of a wound infection associated with E. cancerogenus have yet been reported in Japan.…”