Causes of Mortality by Autopsy Findings of Combat Casualties and Civilian Patients Admitted to a Burn Unit

Gómez, Rubén Sánchez; Murray, Clinton K.; Hospenthal, Duane R.; Cancio, Leopoldo C.; Renz, Evan M.; Holcomb, John B.; Wade, Charles E.; Wolf, Steven E.

doi:10.1016/j.jamcollsurg.2008.11.012

Cited by 116 publications

(84 citation statements)

References 39 publications

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“…This lack of concordance is not unfounded, with previous studies having demonstrated little concordance between bacteria identified through traditional methods of culture in antemortem and post-mortem clinical samples [33,34]. Of the 12 BAL samples examined in the present study, both culture and the NGS method identified the same predominant species (Haemophilus sp.)…”

Section: Discussioncontrasting

confidence: 58%

Examination with Next-Generation Sequencing Technology of the Bacterial Microbiota in Bronchoalveolar Lavage Samples after Traumatic Injury

Huebinger

Liu

Dowd³

et al. 2013

Surgical Infections

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Background: We examined the microbiota of bronchoalveolar lavage (BAL) samples with next-generation sequencing (NGS) technology to determine whether its results correlate with those of standard culture methods or affect patient outcome or both. Methods: We collected BAL samples in the surgical intensive care unit (SICU) as part of the standard of care for intubated individuals who had a Clinical Pulmonary Infection Score (CPIS) ‡ 6 points. A portion of the BAL fluid was sequenced for the 16S region of ribosomal deoxyribonucleic acid (rDNA) with the Roche 454 FLX Titanium sequencer. Sequences were analyzed through a data-analysis pipeline to identify the appropriate taxonomic designation (*species) of each 16s sequence. The bacterial microbiota of each BAL sample was compared with the bacteria identified in the sample through standard culture methods. Correlations between the taxonomic diversity of the microbiota and clinical outcome were examined through linear regression and Pearson correlation. Results: Bronchoalveolar lavage samples from 12 individuals in the SICU who had a CPIS ‡ 6 points were examined through 454 pyrosequencing. The number of phylotypes (*species) in the samples ranged from 15 to 129. The number of phyla in the BAL samples ranged from 3 to 14. There was little correlation between the bacteria identified by NGS and those identified with standard culture methods. The same predominant bacterial strain was identified by both culture and sequencing in only a single sample. The correlation between patient days on a ventilator and the number of species in BAL samples was significant (r = 0.7435, p = 0.0056; r 2 = 0.5528). Conclusions: Increasing diversity of the bacterial microbiota in BAL samples correlates with the duration of mechanical ventilation. Bacteria identified through standard culture methods were not well correlated with the findings of NGS.

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Section: Discussioncontrasting

confidence: 58%

Examination with Next-Generation Sequencing Technology of the Bacterial Microbiota in Bronchoalveolar Lavage Samples after Traumatic Injury

Huebinger

Liu

Dowd³

et al. 2013

Surgical Infections

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“…Patients who perish after surviving the initial burn insult and resuscitation are most likely to die from infectious complications [1]. Burn patients are relatively immunosuppressed and are at high risk of infections, in particular with nosocomially-acquired multi-drug-resistant (MDR) organisms [2]. Burns result in loss of the first line of immunologic defense, the skin, and burn eschar is avascular.…”

Section: Introductionmentioning

confidence: 99%

Activity of topical antimicrobial agents against multidrug-resistant bacteria recovered from burn patients

Glasser

Guymon

Mende

et al. 2010

Burns

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“…The most cited reason for death in burned patients is infection [1,2], noted as the most common complication in patients of all ages by the American Burn Association. Burn injuries destroy the physical skin barrier that normally prevents the invasion of microorganisms, thereby providing novel sites for bacterial colonization, potentially leading to invasive infection and even sepsis [3].…”

mentioning

confidence: 99%

Local Probiotic Therapy with Lactobacillus plantarum Mitigates Scar Formation in Rabbits after Burn Injury and Infection

Satish

Gallo

Johnson

et al. 2017

Surgical Infections

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Background: Infection is the most common complication in burn-injured patients and is believed to contribute to the hypertrophic scarring frequently observed in such injury. Pseudomonas aeruginosa is a common pathogen in burn wound infection. We examined the effect of local probiotic therapy with Lactobacillus plantarum on the severity of the scarring following burn wounding and infection with P. aeruginosa in a rabbit model. Methods: Full-thickness burn wounds were inoculated with control vehicle or L. plantarum; wounds were then challenged with bioluminescent P. aeruginosa. The time course of the ensuing infection was monitored by quantification of the emitted light. After allowing wounds to contract to near completion, they were harvested and analyzed for markers of scar formation. Results: Application of L. plantarum curtailed both the severity and the length of the pseudomonal infection. Probiotic therapy significantly reduced both Type I collagen mRNA concentrations and total collagen protein accumulation in infected wounds, consistent with reduced scarring. Surprisingly, the probiotic showed a nearly equivalent effect in uninfected wounds. Masson's trichrome staining confirmed these findings histologically. Conclusions: Lactobacillus plantarum shows exciting potential as a therapeutic agent to both counteract burn wound infection and to alleviate scarring even in the absence of infection.

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Causes of Mortality by Autopsy Findings of Combat Casualties and Civilian Patients Admitted to a Burn Unit

Cited by 116 publications

References 39 publications

Examination with Next-Generation Sequencing Technology of the Bacterial Microbiota in Bronchoalveolar Lavage Samples after Traumatic Injury

Examination with Next-Generation Sequencing Technology of the Bacterial Microbiota in Bronchoalveolar Lavage Samples after Traumatic Injury

Activity of topical antimicrobial agents against multidrug-resistant bacteria recovered from burn patients

Local Probiotic Therapy with Lactobacillus plantarum Mitigates Scar Formation in Rabbits after Burn Injury and Infection

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