Microbial profiles and risk of amputation in fasciotomy and open wounds following the 2023 Türkiye earthquakes

Sep 30, 2026

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Retrospective single-center analysis evaluated microbial profiles of wound infections after the February 6, 2023 Kahramanmaraş earthquakes and assessed their association with amputation risk. Ninety-five adults with post-earthquake wound infections and positive cultures were included, with 50 in the fasciotomy group and 45 in the open wound group. Acinetobacter spp. was the most frequently isolated organism, with higher isolation in fasciotomy (40% vs. 11.1%, p=0.0021) and carbapenem resistance in 86.5% of isolates. High-resistance Acinetobacter infections may represent a potential amputation risk factor.

LanguageEnglish

CategoryHealthcare

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Pages8

Reading Time20 min

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Abstract

Background

Methods

Results

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Study context and rationale

ORIGINAL ARTICLE Microbial profiles and risk of amputation in fasciotomy and open wounds following the 2023 Türkiye earthquakes Halil Gök,1 Berna Çatıkkaş,2 Semanur Kuzi,3 Alişan Daylak,1 ErkanAkgün,4 Mehmet Yasin Armağan,1 Hamisi Mwarindano Mraja,5 Kadir Çevik,6 Alim Can Baymurat7 1Department of Orthopedics and Traumatology, Ankara Etlik City Hospital, Ankara-Türkiye 2Department of Physics, Hatay Mustafa Kemal University, Hatay-Türkiye 3Department of Infectious Diseases and Clinical Microbiology, Ankara Etlik City Hospital, Ankara-Türkiye 4Department of Orthopedics and Traumatology, Lokman Hekim Etlik Hospital, Ankara-Türkiye 5Scoliosis-Spine Center, Istanbul Florence Nightingale Hospital, İstanbul-Türkiye 6Department of Orthopedics and Traumatology, Başakşehir Çam and Sakura City Hospital, İstanbul-Türkiye 7Department of Orthopedics and Traumatology, Gazi University Faculty of Medicine, Ankara-Türkiye ABSTRACT BACKGROUND: This retrospective, single-center study aimed to evaluate the microbial profiles of wound infections due to extremity injuries after the February 6, 2023 Kahramanmaraş earthquakes and their association with the risk of amputation. METHODS: The study included 95 adult patients with post-earthquake wound infections and positive cultures—50 in the fasciotomy group and 45 in the open wound group. RESULTS: The most frequently isolated microorganism was Acinetobacter spp. and the isolation rate of this pathogen was significantly higher in the fasciotomy group than in the open wound group (40% vs. 11.1%; p=0.0021). Although the Escherichia coli isolation rate was higher in the open wound group, this difference was not statistically significant. Polymicrobial infection rates were similar in both groups. Antibiotic susceptibility analysis showed that 86.5% of Acinetobacter spp. isolates were resistant to carbapenems and 10.8% to colistin. The isolation rate of Acinetobacter spp. was higher in patients who underwent amputation (35.14%) compared to those who did not (20.69%), but this difference did not reach statistical significance. CONCLUSION: Our findings suggest that the pathogen profile in post-earthquake wound infections may vary according to wound type and that Acinetobacter spp. infections with high antibiotic resistance may be a potential risk factor for amputation. In conclusion, resource-based evaluation of post-disaster wound infections, planning early and targeted treatment strategies, and developing effective approaches against highly resistant pathogens are critical for reducing the risk of amputation. Keywords: Earthquake; open wound; fasciotomy; infection; amputation. INTRODUCTION On February 6, 2023, two devastating earthquakes measuring 7.8 Mw and 7.5 Mw, respectively, struck the southern region of Türkiye within a nine-hour interval along distinct fault lines. These seismic events had catastrophic consequences, directly affecting eleven provinces—most notably Hatay (Antakya), Kahramanmaraş, Gaziantep (Nurdağı and Islahiye), Adıyaman (Gölbaşı), Malatya, and northern Syria—resulting in more than 53,000 fatalities, 108,068 injuries, and the displacement of over 1.2 million individuals.[1] Cite this article as: Gök H, Çatıkkaş B, Kuzi S, DaylakA, Akgün E, Armağan MY, et al. Microbial profiles and risk of amputation in fasciotomy and open wounds following the 2023 Türkiye earthquakes. Ulus Travma Acil Cerrahi Derg 2025;31:951-958. Address for correspondence: Berna Çatıkkaş Department of Physics, Hatay Mustafa Kemal University, Hatay, Türkiye E-mail: [berna@mku.edu.tr](berna@mku.edu.tr) Ulus Travma Acil Cerrahi Derg 2025;31(10):951-958 DOI: 10.14744/tjtes.2025.99650 Submitted: 02.07.2025 Revised: 11.07.2025 Accepted: 11.09.2025 Published: 07.10.2025 OPEN ACCESS This is an open access article under the CC BY-NC license ([http://creativecommons.org/licenses/by-nc/4.0/](http://creativecommons.org/licenses/by-nc/4.0/)). Ulus Travma Acil Cerrahi Derg, Octo

FAQs

What was the main purpose of the study?

To evaluate microbial profiles of wound infections after the February 6, 2023 Kahramanmaraş earthquakes and determine whether these profiles were associated with the risk of amputation.

How many patients were included, and how were they grouped?

Ninety-five adult patients with post-earthquake wound infections and positive cultures were included: 50 in the fasciotomy group and 45 in the open wound group.

Which microorganism was most frequently isolated and how did it differ by wound type?

Acinetobacter spp. was the most frequently isolated organism, and its isolation rate was significantly higher in the fasciotomy group than in the open wound group (40% vs. 11.1%, p=0.0021).

What did the antibiotic susceptibility results suggest?

Antibiotic susceptibility analysis showed that 86.5% of Acinetobacter spp. isolates were resistant to carbapenems, and 10.8% were resistant to colistin, supporting concern about highly resistant pathogens.

Sep 30, 2026

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