[The present status, counter-measures and new trends on burn infection]
1Institute of Burn Research , State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University, Chongqing 400038, P. R. China.
Abstract:
In recent fifty years, Pseudomonas aeruginosa and Staphylococcus aureus were continuously the predominant in burn infections, the only change seen was a rapid increase in their drug-resistance. Under the pressure of antibiotics, Some opportunistic bacteria that were resistant to all available antibiotics emerged, such as Acinetobacter baumanii and Maltophilia stenotrophomonas. For critically burn patients, basing on early surgical intervention, early and short-term use of broad-spectrum antibiotic is advisable, and it may control the infection promptly, prevent further inflammatory reaction, as well as minimize the emergence of antibacterial resistance. To control infections due to pandrug-resistant bacteria, cyclic use of some old antibiotics may be helpful. In dealing with severe infection, a combination of anti-pathogen and anti-inflammatory reaction measures should be considered.
Insights
Pseudomonas aeruginosa and Staphylococcus aureus are leading burn pathogens, with increasing drug resistance. Strategies like early intervention and cyclic antibiotic use combat resistant bacteria and severe infections.
Area of Science:
- Infectious Diseases
- Microbiology
- Burn Care
Context:
- Over 50 years, Pseudomonas aeruginosa and Staphylococcus aureus consistently dominate burn infections.
- A significant rise in antibiotic resistance among these pathogens is observed.
- Emergence of pandrug-resistant opportunistic bacteria like Acinetobacter baumanii and Stenotrophomonas maltophilia poses a critical threat.
Purpose:
- To review current strategies for managing burn wound infections, focusing on antibiotic resistance.
- To provide recommendations for optimizing antibiotic use in critically burned patients.
- To explore novel approaches for combating pandrug-resistant bacterial infections.
Summary:
- Critically burned patients benefit from early surgical intervention combined with short-term, broad-spectrum antibiotic use to control infection and inflammation, minimizing resistance.
- Cyclic administration of older antibiotics may be effective against pandrug-resistant bacteria.
- Comprehensive management of severe infections requires a dual approach targeting both the pathogen and the inflammatory response.
Impact:
- Informing clinical practice for improved burn wound infection management.
- Guiding antibiotic stewardship to mitigate the development of antimicrobial resistance.
- Highlighting the need for innovative strategies against multidrug-resistant organisms in critical care settings.
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