Sepsis in burned patients

Macedo, Jefferson Lessa Soares de; Rosa, Simone Corrêa; Castro, Cleudson

doi:10.1590/s0037-86822003000600001

Cited by 32 publications

(23 citation statements)

References 25 publications

(1 reference statement)

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“…Converging with our data is the work of Williams et al (2009) [37] who obtained 43 days of hospitalization in patients with sepsis on average, 26 days in patients with respiratory disorders and 7 days in patients presenting with cardiogenic shock secondary to hypovolemia, showing that depending on the course and characteristics of trauma we may have changes in survival time [5].…”

Section: Discussionsupporting

confidence: 81%

Factors associated with survival of burned patients

et al. 2015

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Background: It is scarce in the literature studies regarding treatment and objective analysis of the survival chances of burned patients. Some investigations indicates the need for obtaining specific data to the population studied and characteristics such as social condition and nutritional status are suggested to be relevant to the patient's evolution. We aimed to describe the mortality of a Treatment Center Burn Unit (BU) in Brazil. Methods:We analyzed 76 burned victims hospitalized with a fatal outcome in the General Hospital of São Matheus in 10 years (1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009). The following collected data were investigated were: age, sex, period of permanence, body surface burned (BSB), degree of burns, the causal agent, inhalation injury, nature of the event, clinical complications, mortality and survival rates. Results:We observed predominantly male and the median age was 44 years old. The highest incidence was on June. The mean body surface area burned was 40%, and upper limbs, the most affected region. The causative agents involved were more flammable agents and fire. Pulmonary infection was the most frequent clinical complication. The mortality found in this center was 4.9%. The subgroup of suicide were predominantly female and the mortality rate was 22.44%. When studying survival rate, patients with inhalation injury and trauma were associated with shorter survival. Patients with sepsis remained alive for longer. Conclusion:The clinical, epidemiological and survival of patients with burns, enables the design of peculiar characteristics of this trauma in the studied area, thus, from these data, charts be established treatment and prognostic estimates, and assist in developing preventive public health policy more effective.

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Section: Discussionsupporting

confidence: 81%

Factors associated with survival of burned patients

et al. 2015

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“…These findings have been consistent worldwide [8,12,20]. Staphylococcus aureus also has been reported as the most common organism isolated from blood culture in burned patients with sepsis [21]. A study of the bacteriological profile and antibiotic resistance in a burn unit in France established S. aureus as the most frequent species, with a methicillin-resistance rate of 68.1% [22].…”

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confidence: 64%

Emerging Infections in Burns

Branski

Al-Mousawi

Rivero

et al. 2009

Surgical Infections

273

158

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Background: Patients who suffer severe burns are at higher risk for local and systemic infections. In recent years, emerging resistant pathogens have forced burn care providers world wide to search for alternative forms of treatment. Multidrug-resistant Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter spp., and various fungal strains have been the major contributors to the increase in morbidity and mortality rates. Multi-drugresistant S. aureus remains the major cause of gram-positive burn wound infections world wide. Treatment strategies include rigorous isolation protocols and new types of antibiotics where necessary. Methods: We reviewed 398 severely burned patients (burns >40% total body surface area [TBSA]) admitted to our hospital between 2000 and 2006. Patients who did not contract multi-drug-resistant gram-negative organisms during their hospital course and received our standard antibiotic regimen-vancomycin and piperacillin= tazobactam-served as controls (piperacillin=tazobactam; n ¼ 280). The treatment group consisted of patients who, during their acute hospital stay, developed infections with multi-drug-resistant gram-negative pathogens and were treated with vancomycin and colistin for at least three days (colistin; n ¼ 118). Results: Gram-negative organisms continue to cause the most severe infections in burn patients. Colistin has reemerged as a highly effective antibiotic against multiresistant Pseudomonas and Acinetobacter infections of burns. Patients who required colistin therapy had a significantly larger average total and full-thickness burn than patients treated with piperacillin=tazobactam and vancomycin, and the mortality rate was significantly higher in the colistin group (p < 0.05). However, there was no significant difference between the colistin and piperacillin= tazobactam groups in the incidence of neurotoxicity, hepatic toxicity, or nephrotoxicity. The main fungal pathogens in burn patients are Candida spp., Aspergillus spp., and Fusarium spp. A definitive diagnosis is more difficult to obtain than in bacterial infections. Amphotericin B and voriconazole remain the two most important anti-fungal substances in our practice. Conclusions: Innovations in fluid management, ventilatory support, surgical care, and antimicrobial therapy have contributed to a significant reduction in morbidity and mortality rates in burn patients. Vancomycin and clindamycin are the two most important reserve antibiotics for methicillin-resistant Staphylococcus aureus infection. Oxazolidinones and streptogramins have showed high effectiveness against gram-positive infections. Colistin has re-emerged as a highly effective antibiotic against multiresistant Pseudomonas and Acinetobacter infections. Current challenges include Candida, Aspergillus, and molds. The development of new agents, prudent and appropriate use of antibiotics, and better infection control protocols are paramount in the ongoing battle against multi-resistant organisms.

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“…O baixo índice de infecção bacteriana secundária indica que as bactérias isoladas agem como microrganismos colonizantes nas úlceras. A colonização bacteriana pode ter um papel importante no aparecimento de infecção da ferida e da sepse em pacientes imunocomprometidos 14 . testados, além disso, tem boa atividade antimicrobiana in vitro contra bactérias Gram-positivas, Escherichia coli e Pseudomonas aeruginosa 2 11 .…”

Section: Discussionunclassified

Sensibilidade antimicrobiana de bactérias aeróbicas isoladas de úlceras leishmanióticas, em Corte de Pedra, BA

Vera

Macedo

Ciuffo

et al. 2006

Rev. Soc. Bras. Med. Trop.

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A lesão cutânea ulcerada, manifestação clínica mais freqüente da leishmaniose tegumentar, geralmente localizada em membros inferiores, permanece ativa durante meses, expondo-se à colonização por microorganismos, componentes ou não da flora normal da pele. As condições de calor, umidade e má higiene, que acontecem freqüentemente em ambiente rural nas regiões tropicais, associadas à proximidade dessas úlceras com o solo, favorecem, sobremodo, a colonização por diversas bactérias 20 .Existem poucos relatos sobre a prevalência de bactérias em úlceras leishmanióticas. ABSTRACTA prospective study regarding aspects of antimicrobial susceptibility aspects was realized among patients with tegumentary leishmaniasis in Corte de Pedra, Bahia. Cases were composed mainly of adolescent and adult farmer patients with single lesions. Staphylococcus aureus predominated (83%) in the culteres with susceptibility to the majority of antibiotics. A mixed bacterial flora in ulcers was encountered in 37 (44,1%) patients. Among the Gram-negative bacteria isolated, Enterobacter sp (13.1%), Proteus sp (8.3%), Pseudomonas aeruginosa (7.1%) and Klebsiella sp (7.1%) were mainly found with susceptibility to ciprofloxacin, aminoglycosides, third generation cephalosporin and carbapenems.

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Sepsis in burned patients

Cited by 32 publications

References 25 publications

Factors associated with survival of burned patients

Factors associated with survival of burned patients

Emerging Infections in Burns

Sensibilidade antimicrobiana de bactérias aeróbicas isoladas de úlceras leishmanióticas, em Corte de Pedra, BA

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