Epidemiological investigation and clinical characteristics study of orthopedic infections caused by Aeromonas in the southeast coastal region from 2018 to 2024.

OBJECTIVE

To investigate the clinical and epidemiological characteristics of trauma-related orthopedic Aeromonas infections and analyze prognostic risk factors to guide early diagnosis and inform clinical management.

METHODS

This retrospective study analyzed 111 patients with traumatic Aeromonas infection from May 2018 to May 2024. Data on demographics, injury characteristics, laboratory parameters, treatment details, and outcomes were collected. Independent predictors of unfavorable prognosis were identified through univariate and multivariate logistic regression, with model performance evaluated via likelihood ratio test, ROC analysis, Hosmer-Lemeshow test, and confusion matrix.

RESULTS

A total of 111 patients with trauma-related Aeromonas infection were collected, with an average age of 49.9 ± 14.3 years. The average length of hospital stay was 36.2 ± 21.1 days, and the average number of surgeries was 2.7 ± 1.6. The outcomes included debridement in 51(45.95%) cases, skin grafting in 17(15.32%) cases, flaps in 27(24.32%) cases, amputation in 14(12.61%) cases, and death in 2(1.80%) cases. The drug sensitivity test results showed that Aeromonas extracted from the wound secretions were resistant to ampicillin and amoxicillin and were sensitive to amikacin, levofloxacin and cefepime. Our research has listed three predictive indicators significantly associated with unfavourable prognosis, mainly including body mass index (BMI), skin defect and perioperative blood transfusion.

CONCLUSION

This study outlines the clinical profile of traumatic Aeromonas infection, which predominantly affects middle-aged individuals and is associated with extended hospital stays, frequent surgical interventions, and significant rates of adverse outcomes, including amputation (12.61%) and mortality (1.80%). Multivariate analysis identified BMI > 23.7 kg/m², skin defects, and perioperative blood transfusion as independent predictors of poor prognosis. For high-risk trauma patients with these factors, our model recommends prophylactic use of third-generation cephalosporins (e.g., ceftazidime), aminoglycosides (e.g., amikacin), or combination therapy in place of first-line cephalosporins. Vigilant perioperative monitoring for invasive infections is crucial, especially in immunocompromised patients. CLINICAL TRIAL NUMBER: Not applicable.