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Abstract:
Ninety-seven of 763 patients admitted to a burn center during a 3-year period had histologically confirmed bacterial or fungal burn wound invasion. Nine of these 97 patients survived and 88 died. Burn wound infection was the principal cause of death in 57 patients and was diagnosed perimortem in an additional 31 patients but was not judged to be the primary cause of death. Pseudomonas aeruginosa continues as the most frequent offending organism. The variety of mycotic and bacterial organisms identified, however, suggests that the compromise of the host is the critical factor, and not any particular microorganism. A variety of combinations of treatments are described: the selection of treatment depends upon the type and extent of infection.
Insights
Severe burn wound infections are often fatal, with bacterial and fungal invasions leading to death in most patients. Host compromise, not specific pathogens like Pseudomonas aeruginosa, is the critical factor in survival. Treatment selection depends on infection type and extent.
Area of Science:
- Infectious Diseases
- Burn Care
- Microbiology
Background:
- Burn wound infections pose a significant threat to patient survival.
- Histologically confirmed invasion occurs in a notable percentage of burn center admissions.
- Identifying causative organisms is crucial for effective treatment strategies.
Purpose of the Study:
- To analyze the incidence and outcomes of burn wound infections.
- To identify the predominant microorganisms involved in fatal burn wound infections.
- To evaluate the role of host compromise versus specific pathogens.
Main Methods:
- Retrospective analysis of 763 burn center admissions over 3 years.
- Histological confirmation of bacterial or fungal burn wound invasion.
- Review of patient survival data and cause of death, including perimortem diagnoses.
Main Results:
- 97 out of 763 patients (12.7%) had confirmed burn wound invasion.
- Only 9 of these 97 patients survived; 88 died.
- Burn wound infection was the primary cause of death in 57 patients and a contributing factor in 31 others.
- Pseudomonas aeruginosa was the most frequent organism, but diverse pathogens were identified.
- Host compromise was deemed more critical than specific microorganisms.
Conclusions:
- Burn wound infections have a high mortality rate, emphasizing the need for aggressive management.
- The diversity of identified pathogens underscores the importance of assessing host immune status.
- Treatment strategies must be tailored to the specific type and extent of infection and the patient's condition.