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Updated: Aug 19, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
Published on: February 9, 2011
Multiple resistant Staphylococcus aureus
1Royal Brisbane Hospital, Herston Post Office, Queensland, Australia.
Abstract:
Burn wound sepsis is still a common cause of death in burn injuries. Eighty percent of this infection is with colonisation from the patient and twenty percent as a result of cross infection. Most of the mortality is due to virulent cross infection. Pseudomonas has almost disappeared and multiple resistant staphylococcus aureus is the main pathogen today. It can cause loss of skin grafts and septicaemia, particularly due to colonisation of intravenous lines. The risk increases with the time since the burn injury. Early excision and grafting is important. With a large burn it is not possible to do this in one session and so the risk is increased with a compromised patient. Maintenance of a good diet and vitamin supplements is important, preferably orally or through a naso-gastric tube. Parenteral nutrition increases the risk of infection. Clinical infection is combated by good cleaning procedures, preferably with chlorhexidine solution and the application of a good topical agent such as Silvazine. The presence of bacteria in the wound must be monitored. Strict barrier nursing and personal hygiene, particularly hand washing, are the mainstay of cross infection prevention. Antibiotics may be required, monitored by blood cultures. Documenting MRSA is a good way to monitor the unit's infection prevention programme. The main preventive measures are early referral, early excision and grafting, good nutritional support, good topical agents and barrier nursing.
Insights
Burn wound sepsis remains a significant cause of death, with virulent cross-infection being the primary mortality driver. Preventing infection through hygiene, early surgical intervention, and nutritional support is crucial for patient survival.
Area of Science:
- Infection Control
- Burn Management
- Microbiology
Background:
- Burn wound sepsis is a major cause of mortality in burn injury patients.
- While Pseudomonas has decreased, multidrug-resistant Staphylococcus aureus is now the primary pathogen, causing graft loss and sepsis.
- Cross-infection poses a higher mortality risk than autogenous colonization.
Purpose of the Study:
- To outline current challenges and preventive strategies for burn wound sepsis.
- To emphasize the importance of infection control in burn care.
- To highlight key interventions for reducing mortality.
Main Methods:
- Review of current pathogens and infection risks in burn patients.
- Discussion of preventive measures including hygiene, nutrition, and surgical techniques.
- Emphasis on monitoring bacterial presence and antibiotic use.
Main Results:
- Multidrug-resistant Staphylococcus aureus is the predominant pathogen, increasing risks with intravenous line colonization and delayed healing.
- Early excision and grafting are critical but challenging in large burns.
- Effective prevention relies on barrier nursing, hygiene, nutritional support, and topical agents.
Conclusions:
- Strict adherence to hygiene protocols, including hand washing and barrier nursing, is essential for preventing cross-infection.
- Optimal nutritional support, preferably oral or via nasogastric tube, is vital.
- A comprehensive approach combining early surgical intervention, vigilant monitoring, appropriate topical agents, and robust infection control practices is key to reducing burn wound sepsis mortality.
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