Contaminated Wounds: Fresh Water, Salt Water, and Agricultural Contamination
- 36 Downloads
Purpose of Review
This review focuses on the appropriate management of contaminated wounds sustained in the freshwater, saltwater, and agricultural settings.
While these wounds can be associated with polymicrobial pathogens and infections, Aeromonas spp. and Mycobacterium marinum are commonly seen in fresh water wounds, while Vibrio vulnificus is a common pathogen in saltwater wounds. Each of these organisms can be extremely virulent. Pathogens found in agricultural contamination can vary widely, but can be associated with fungal organism found in the soil. Management of these soft tissue injuries includes early irrigation and debridement, avoiding primary closure, and appropriate antibiotic selection.
This review will highlight the most common pathogens found in contaminated wounds and highlight their virulence and potential for life-threatening systemic illness from wound infections. We also discuss appropriate antibiotic selection for these pathogens and our practices for wound management.
KeywordsSalt water infection Fresh water infection Contaminated wound Aeromonas Vibrio
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflicts of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance
- 13.Centers for Disease Control and Prevention (CDC). Vibrio illnesses after Hurricane Katrina—multiple states, August-September 2005. MMWR Morb Mortal Wkly Rep. 2005;54:928–31.Google Scholar
- 16.• Finkelstein R, Oren I. Soft tissue infections caused by marine bacterial pathogens: epidemiology, diagnosis, and management. Curr Infect Dis Rep 11 ed. Current Science Inc; 2011;13:470–477. Review article on pathogens, clinical manifestations, and treatment of fresh and salt water related infections. CrossRefGoogle Scholar
- 20.Grim CJ. Aeromonas and Plesiomonas. In: Foodborne infections and intoxications: Elsevier; 2013. p. 229–37.Google Scholar
- 22.Koth K, Boniface J, Chance EA, Hanes MC. Enterobacter asburiae and Aeromonas hydrophila: soft tissue infection requiring debridement. Orthopedics SLACK Incorporated. 2012;35:e996–9.Google Scholar
- 30.Appelgren P, Farnebo F, Dotevall L, Studahl M, Jönsson B, Petrini B. Late-onset posttraumatic skin and soft-tissue infections caused by rapid-growing mycobacteria in tsunami survivors. Clinical Infectious Diseases Oxford University Press; 2008;47:e11–6.Google Scholar
- 33.Gilbert DN. The Sanford guide to antimicrobial Therapy 2012.2012.Google Scholar
- 35.ATLS Subcommittee. American College of Surgeons’ Committee on Trauma, International ATLS working group. Advanced trauma life support (ATLS®): the ninth edition. J Trauma Acute Care Surg 2013. 74:1363–6.Google Scholar
- 40.Wright AC, Hill RT, Johnson JA, Roghman MC, Colwell RR, Morris JG. Distribution of Vibrio vulnificus in the Chesapeake Bay. Appl. Environ. Microbiol. American Society for Microbiology (ASM); 1996;62:717–724.Google Scholar
- 41.Levine WC, Griffin PM. Vibrio infections on the Gulf Coast: results of first year of regional surveillance. Gulf Coast Vibrio Working Group J Infect Dis. 1993;167:479–83.Google Scholar
- 44.Ryan WJ. Marine vibrios associated with superficial septic lesions. J Clin Pathol BMJ Publishing Group. 1976;29:1014–5.Google Scholar
- 45.Bisharat N, Agmon V, Finkelstein R, Raz R, Ben-Dror G, Lerner L, et al. Clinical, epidemiological, and microbiological features of Vibrio vulnificus biogroup 3 causing outbreaks of wound infection and bacteraemia in Israel. Israel Vibrio Study Group Lancet. 1999;354:1421–4.Google Scholar