https://doi.org/10.4081/ecj.2026.14710
Microbiological resistance patterns and outcomes in trauma patients
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Published: 14 July 2026
The initial assessment and stabilization of a traumatized patient is of paramount importance. Post-traumatic infections have long been considered among the leading causes and contributing factors of outcomes such as mortality, complications, and Length Of Hospital Stay (LOHS). This is an observational study using data prospectively collected within the "trauma registry" database of the General and Emergency Surgery department of the Pisa University Hospital - Trauma Center of Cisanello (Pisa), collected from November 2019 to December 2021. Epidemiological, clinical and microbiological data have been registered for all patient. Details regarding those who developed infections were analyzed. Among the 533 patients examined, 75 people developed an infection (signs like fever, WBC count increase, infectious protein related) with at least one positive microbiological isolate during hospitalization, for a total of 234 positive isolates, among which pathogens Resistant (R) to one class of antimicrobials and pathogens resistant to more than three classes of antimicrobials (Multi-drug Resistant, MDR) were identified. Multivariate analyses were performed to correlate trauma severity (Injury Severity Score, ISS), general population characteristics and microbiological patterns with outcomes. The presence of resistant strains identified in the second culture test together with ICU admission were found to be risk factors associated to the development of complications. Microbiological patterns were not statistically significant risk factors for mortality. A multidisciplinary team plays a pivotal role in defining the correct antibiotic stewardship program.
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Ethics Approval
CRediT authorship contribution
Federico Coccolini, Riccardo Guelfi, Antonella Lupetti, Nicola Pagnucci, conceptualization; Riccardo Guelfi, Alessandro Cipriano, Greta Barbieri, Camilla Cremonini, Riccardo Morganti, methodology; Riccardo Guelfi, Benedetta Tuvo, Iacopo Franconi, Camilla Cremonini, Greta Barbieri, data collection; Camilla Cremonini, Riccardo Morganti, formal analysis and investigation; Riccardo Guelfi, Alessandro Cipriano, Nicola Pagnucci, writing - original draft preparation; Federico Coccolini, Antonella Lupetti, Dario Tartaglia, Lorenzo Ghiadoni, Ettore Melai, writing - review and editing; Federico Coccolini, Massimo Chiarugi, Antonella Lupetti, Lorenzio Ghiadoni, supervision.
Data Availability Statement
All data generated or analyzed during this study are included in this published article.
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