Bacterial and fungal colonization of burn wounds

Macedo, Jefferson Lessa Soares de; Santos, João Barberino

doi:10.1590/s0074-02762005000500014

Cited by 105 publications

(63 citation statements)

References 19 publications

(21 reference statements)

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“…In conclusion, burn-induced suppression of humoral and cell-mediated immunity makes burn patients susceptible to various infections (de Macedo and Santos, 2005;Stoilova, et al, 2007;Rezaei et al, 2011). As such, the cimetidine ability to 'restore' IL-2, -10, -12, and -17 production, as well as DTH responses, that was demonstrated in the present studies represents a noteworthy set of outcomes.…”

Section: Discussionsupporting

confidence: 59%

Cimetidine enhances delayed-type hypersensitivity responses and serum interleukin (IL)-2, -10, -12, and IL-17 levels after burn injury in an animal model

Jafarzadeh¹,

Nemati²,

Rezayati³

et al. 2012

Journal of Immunotoxicology

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Section: Discussionsupporting

confidence: 59%

Cimetidine enhances delayed-type hypersensitivity responses and serum interleukin (IL)-2, -10, -12, and IL-17 levels after burn injury in an animal model

Jafarzadeh¹,

Nemati²,

Rezayati³

et al. 2012

Journal of Immunotoxicology

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“…Historically, group A beta-hemolytic Streptococcus was the most frequent cause of life-threatening burn wound and systemic infections [14]. The use of penicillin altered the spectrum of gram-positive pathogens, leading to the emergence of S. aureus as the most common gram-positive early colonizer of the burn wound [8,15].…”

Section: Methicillin-resistant Staphylococcus Aureusmentioning

confidence: 99%

Emerging Infections in Burns

Branski

Al-Mousawi

Rivero

et al. 2009

Surgical Infections

274

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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“…It is very crucial for every burn institution to determine the specific pattern of burn wound microbial colonization, the time related changes in the dominant flora and the antimicrobial sensitivity profiles. 10 The increase rate of burn wound infection and sepsis is due to overcrowding (such as in developing countries), inadequate sterilization and disinfection practices, gross contamination of environment, and lack of isolation facilities, inadequate hand washing and absence of barrier nursing. 11 Patients have to stay for long period in the hospital and many intravascular and other devices are put in them.…”

Section: Introductionmentioning

confidence: 99%

Time Related Changes in Pathogenic Bacterial Patterns in Burn Wound Infections and Their Antibiotic Sensitivity Traits

Mehta

Singh²,

Sawhney

et al. 2017

Bangladesh J Med Sci

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Objectives: To examine the time related changes in the bacterial flora isolated from the burn patients and to compare the antibiograms of the predominant bacteria. Burn injuries constitute a major health concern with respect to morbidity and mortality as well as cost of management particularly in developing countries. It has been estimated that 75% of all deaths following thermal injuries are related to infection. It is essential for every hospital to determine the specific pattern of burn wound microbial colonization, time-related changes in predominant flora and anti microbial sensitivity profiles. Materials and Methods: 60 burn patients and their microbial isolates were examined during the study period. Periodic swabs were taken from burn wounds of the patients on admission and on 7th, 14th, and 21st days of hospitalization and the isolates were processed for culture, identification and antimicrobial sensitivity as per CLSI guidelines. Results: Among the 240 samples, single organism was isolated in 161 samples (67.1%) and mixed organisms in 22 samples (9.1 %) and no growth in 57 samples (23.7%). Among single isolates pseudomonas aerugenosa was predominant species (20.8%) followed by acinetobacter baumanii (15.4%), staph. aureus (14.1%) and klebsiella (7.5%). Among mixed growth pseudomonas was predominant species (30.4%) followed by acinetobacter (23.9%). klebsiella (17.4 %) and staph. aureus (10.8%). There was time related changes in bacterial isolation from burn wound during hospital stay of patients. On admission, Staph. Aureus was 18.3 %, pseudomonas was 8.3% and klebsiella was 6.6%. No growth found in 48.3% samples. These findings gradually changed with time and on day 21 Pseudomonas was 30% followed by Acinetobacter sp. (21.6%), Staph. aureus (13.3%) and Klebsella pneumoniae (6.6%). No growth was seen in 15% cases only. Antimicrobial sensitivity test showed that pseudomonas was sensitive to Imipenem, Merepenem and Ampicillin. Acinetobacter was also found most sensitive to Amikacin and Tetracycline, followed by Tobramycin. Staphylococcus aureus was sensitive to Linezolid, Gentamycin followed by Vancomycin. Conclusion: There were timerelated changes in microbial colonization during hospital stay of patients. Effective protocols should be made for burn patients and effort is needed for improving overall infection related morbidity and mortality.

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Bacterial and fungal colonization of burn wounds

Cited by 105 publications

References 19 publications

Cimetidine enhances delayed-type hypersensitivity responses and serum interleukin (IL)-2, -10, -12, and IL-17 levels after burn injury in an animal model

Cimetidine enhances delayed-type hypersensitivity responses and serum interleukin (IL)-2, -10, -12, and IL-17 levels after burn injury in an animal model

Emerging Infections in Burns

Time Related Changes in Pathogenic Bacterial Patterns in Burn Wound Infections and Their Antibiotic Sensitivity Traits

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