[Infection in burn patients: the problems of pathogenesis, prevention and treatment]

Urgent issues of pathogenesis, prophylaxis and treatment of infection in patients with thermal injuries are considered. Analysis of the results of multifactorial dynamic examinations of immunological reactivity and nonspecific resistance of 198 burnet patients is presented. For the first time a substantial decrease of B-lymphocytes count in normal or elevated level of immunoglobulins of the main classes is shown as well as a decrease in plasma fibronectin content. Lowering of T-lymphocytes content and polymorphonuclear leucocytes function disturbances, dominant role of St. aureus and P. aeruginosa in etiology of infections in burnt patients and high antibiotic resistance of these microorganisms are demonstrated. Pathogenetic substantiation of combined therapeutic usage of thymus and interferon preparations and when indicated--immunoglobulines is recorded. Positive experience in application of recombinant interleukine-2 (Ronkoleukine) is outlined. The data are provided on advisability of application of new cephalosporines and fluorine-quinolones for antibiotic therapy and prophylaxis in the burnet. In complicated forms of gram-negative infections the combination of aminoglycosides with ureidopenicillines or cyprofloxacine is recommended, in infections provoked by polyresistant strains of S. aureus vancomycin is indicated. With prophylactic aim in case of early surgical treatment it is recommended to apply modern antibacterial preparations with broad spectrum of action. Prophylaxis of hospital infections inpatients of specialised clinics for the burnt is discussed.