Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jun 1;36(6):309-316.
doi: 10.1097/BOT.0000000000002314.

Microbial Interspecies Associations in Fracture-Related Infection

Ida Gitajn  1 , Paul Werth  1 , Robert V O'Toole  2 , Mandarin Joshi  2 , David Jevsevar  1 , Brent Wise  2 , Ajinya Rane  2 , Steven Horton  2 , Emily A McClure  3 , Benjamin Ross  3 , Carey Nadell  4
Affiliations

Microbial Interspecies Associations in Fracture-Related Infection

Ida Gitajn et al. J Orthop Trauma. .

Abstract

Objectives: Describe co-occurrence or clustering of microbial taxa in fracture-related infections to inform further exploration of infection-related interactions among them.

Design: Retrospective review.

Setting: Level 1 trauma center.

Patients/participants: Four hundred twenty-three patients requiring surgical intervention for deep surgical site infection between January 2006 and December 2015.

Intervention: None.

Main outcome measurement: Connection between microbial taxa.

Results: Methicillin-resistant Staphylococcus aureus, methicillin-sensitive Staphylococcus aureus, and coagulase-negative Staphylococcus represented the majority of monomicrobial observations (71%). Gram-negative rods, gram-positive rods, and anaerobes presented more frequently in polymicrobial infections. Enterobacter, vancomycin-sensitive Enterococcus, and Pseudomonas are present in polymicrobial infections with the highest frequencies and represent the top 3 most important nodes within the microorganism framework, with the highest network centrality scores.

Conclusions: The present study indicates that there are common microbial taxa (Enterobacter, Enterococcus, and Pseudomonas) that tend to co-occur with other microbes greater than 75% of the time. These commonly co-occurring microbes have demonstrated interactive relationships in other disease pathologies, suggesting that there may be similar important interactions in fracture-related infections. It is possible that these microbial communities play a role in the persistently high failure rate associated with management of infection after trauma. Future studies are needed to study the intermicrobial interactions that explain the frequency at which taxa co-occur. Understanding and potentially disrupting these intermicrobial relationships could inform improvements in the treatment of established infections and in the prevention of infection in high-risk patients.

Level of evidence: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflict of interest.

References

    1. Bosse MJ, MacKenzie EJ, Kellam JF, et al. An analysis of outcomes of reconstruction or amputation after leg-threatening injuries. N Engl J Med. 2002;347:1924–1931.
    1. Harris AM, Althausen PL, Kellam J, et al. Complications following limb-threatening lower extremity trauma. J Orthop Trauma. 2009;23:1–6.
    1. Keeling JJ, Gwinn DE, Tintle SM, et al. Short-term outcomes of severe open wartime tibial fractures treated with ring external fixation. J Bone Joint Surg Am. 2008;90:2643–2651.
    1. Lerner A, Fodor L, Soudry M. Is staged external fixation a valuable strategy for war injuries to the limbs? Clin Orthop. 2006;448:217–224.
    1. Owens BD, Kragh JF Jr, Wenke JC, et al. Combat wounds in operation Iraqi Freedom and operation enduring freedom. J Trauma. 2008;64:295–299.

MeSH terms

Substances