Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2026
The injury site of severe acute polytrauma complicated by Vibrio vulnificus infection determines clinical outcomes in Beagle models.
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Liu Haoru, Zhang Hao, Huang Yang, Fei Jinzhong, Ma Wei, Shu Junjie, Liang Huaping, Yang Xia
Аннотация
PURPOSE: This study aimed to evaluate the role of the injury site in polytrauma in determining outcomes following challenge with the same inoculum.
METHODS: In this experimental animal study, 19 adult male Beagle dogs weighing 8.2 - 10.0 kg were used. Adult male Beagles were randomly assigned to groups: V1 (limb amputation), V2 (blunt costal trauma combined with penetrating abdominal injury), V3 (tracheal rupture suture with small intestinal injury), and a control group. Following an 8 h baseline period for physiological monitoring, all animals received a standardized inoculum of Vibrio vulnificus (V. vulnificus) directly at the injury site. Organ function, respiratory performance, and blood gas parameters were assessed at 14 h post-infection, with reference to the time of onset of clinical symptoms. Longer observation was precluded by mortality. At the end of the observation period, all animals were euthanized. Serum and organ samples were collected for subsequent analysis. All statistical analyses were performed using GraphPad Prism 9.4. Quantitative data were expressed as mean ± standard errors of the means. Intergroup comparisons were conducted using two-tailed unpaired Student's t-tests or one-way analysis of variance with Tukey's multiple comparisons test.
RESULTS: Following injury, all Beagles exhibited the classic "traumatic death triad" (hypothermia, acidosis, and coagulopathy) and developed fever after V. vulnificus challenge. Compared with the trauma-only control group, the V1 and V3 groups showed decreased red blood cell parameters (group V1: (6.630 ± 0.452) vs. (7.867 ± 0.274) × 1012/L; group V3: (7.250 ± 0.278) vs. (8.110 ± 0.370) × 1012/L), elevated lymphocyte counts (group V1: (1.460 ± 0.473) vs. (1.137 ± 0.068); group V3: (1.640 ± 0.431) vs. (0.767 ± 0.084) × 109/L), and pCO2 (group V1: (57.667 ± 2.728) vs. (51.667 ± 1.333) mmHg; group V3: (60.667 ± 3.712) vs. (50.667 ± 3.180) mmHg). In contrast, the V2 group presented with acidosis and compensatory imbalance. Critically, functional and histologic assessments revealed that the V2 group sustained the most severe lung injury, characterized by reduced respiratory movement, hemorrhage, and marked inflammation, and carried the highest pulmonary bacterial load (174.00 ± 153.70) CFU. While the V1 and V3 groups demonstrated predominantly hepatic involvement, the V2 group exhibited broader multi-organ impairment affecting the liver, kidney, and muscles. The highest muscle bacterial load was recorded in the V3 group (357.34 ± 206.31) CFU.
CONCLUSION: The site and type of polytrauma during the acute phase influence both the severity and organ tropism of subsequent V. vulnificus infection. For instance, even minor chest trauma combined with V. vulnificus infection (the V2 group) led to significantly worse outcomes, including impaired pulmonary function, more severe sepsis, and a heightened risk of multiple organ failure. These findings offer important translational evidence to support clinical prognosis assessment in patients with varying trauma patterns or multiple injuries.
METHODS: In this experimental animal study, 19 adult male Beagle dogs weighing 8.2 - 10.0 kg were used. Adult male Beagles were randomly assigned to groups: V1 (limb amputation), V2 (blunt costal trauma combined with penetrating abdominal injury), V3 (tracheal rupture suture with small intestinal injury), and a control group. Following an 8 h baseline period for physiological monitoring, all animals received a standardized inoculum of Vibrio vulnificus (V. vulnificus) directly at the injury site. Organ function, respiratory performance, and blood gas parameters were assessed at 14 h post-infection, with reference to the time of onset of clinical symptoms. Longer observation was precluded by mortality. At the end of the observation period, all animals were euthanized. Serum and organ samples were collected for subsequent analysis. All statistical analyses were performed using GraphPad Prism 9.4. Quantitative data were expressed as mean ± standard errors of the means. Intergroup comparisons were conducted using two-tailed unpaired Student's t-tests or one-way analysis of variance with Tukey's multiple comparisons test.
RESULTS: Following injury, all Beagles exhibited the classic "traumatic death triad" (hypothermia, acidosis, and coagulopathy) and developed fever after V. vulnificus challenge. Compared with the trauma-only control group, the V1 and V3 groups showed decreased red blood cell parameters (group V1: (6.630 ± 0.452) vs. (7.867 ± 0.274) × 1012/L; group V3: (7.250 ± 0.278) vs. (8.110 ± 0.370) × 1012/L), elevated lymphocyte counts (group V1: (1.460 ± 0.473) vs. (1.137 ± 0.068); group V3: (1.640 ± 0.431) vs. (0.767 ± 0.084) × 109/L), and pCO2 (group V1: (57.667 ± 2.728) vs. (51.667 ± 1.333) mmHg; group V3: (60.667 ± 3.712) vs. (50.667 ± 3.180) mmHg). In contrast, the V2 group presented with acidosis and compensatory imbalance. Critically, functional and histologic assessments revealed that the V2 group sustained the most severe lung injury, characterized by reduced respiratory movement, hemorrhage, and marked inflammation, and carried the highest pulmonary bacterial load (174.00 ± 153.70) CFU. While the V1 and V3 groups demonstrated predominantly hepatic involvement, the V2 group exhibited broader multi-organ impairment affecting the liver, kidney, and muscles. The highest muscle bacterial load was recorded in the V3 group (357.34 ± 206.31) CFU.
CONCLUSION: The site and type of polytrauma during the acute phase influence both the severity and organ tropism of subsequent V. vulnificus infection. For instance, even minor chest trauma combined with V. vulnificus infection (the V2 group) led to significantly worse outcomes, including impaired pulmonary function, more severe sepsis, and a heightened risk of multiple organ failure. These findings offer important translational evidence to support clinical prognosis assessment in patients with varying trauma patterns or multiple injuries.