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The effect of burn wound surgery and teicoplanin on the bactericidal activity of polymorphonuclear leucocytes against
J A Steer1, G B Hill, A P Wilson
1Department of Clinical Microbiology, University College Hospital, London, UK.
Abstract:
Polymorphonuclear leucocyte (PMN) function is suppressed for several weeks after burn injury, rendering patients susceptible to infection, commonly with Staphylococcus aureus. A study was performed to determine the effects of surgery to the burn wound and antimicrobial prophylaxis with teicoplanin on killing of S. aureus by PMNs taken from burn patients. The bactericidal rate was significantly reduced before surgery compared to controls (P < 0.01 Mann Whitney), but neither surgery nor teicoplanin had any significant additional effect on the bactericidal rate. The bactericidal rate of PMNs did not have any significant effect on clinical outcome following surgery.
Insights
Burn injury impairs polymorphonuclear leucocyte (PMN) function, increasing infection risk. Surgery and teicoplanin did not improve PMN killing of Staphylococcus aureus, nor did PMN function impact clinical outcomes post-surgery.
Area of Science:
- Immunology
- Infectious Diseases
- Surgical Infections
Background:
- Burn injury significantly suppresses polymorphonuclear leucocyte (PMN) function for weeks.
- This immune suppression increases patient susceptibility to bacterial infections, particularly Staphylococcus aureus.
- Effective PMN function is crucial for controlling post-burn infections.
Purpose of the Study:
- To investigate the impact of burn wound surgery on PMN bactericidal activity.
- To evaluate the effect of teicoplanin antimicrobial prophylaxis on PMN killing of S. aureus.
- To determine the correlation between PMN bactericidal rates and clinical outcomes after surgery.
Main Methods:
- Collection of PMNs from burn patients before and after surgery.
- Assessment of PMN bactericidal activity against Staphylococcus aureus.
- Comparison of bactericidal rates between pre-surgery, post-surgery, and control groups.
- Analysis of the effect of teicoplanin administration on PMN function.
Main Results:
- PMN bactericidal rates were significantly reduced in burn patients before surgery compared to controls (P < 0.01).
- Neither surgical intervention nor teicoplanin prophylaxis demonstrated a significant additional effect on improving PMN bactericidal rates.
- The study found no significant correlation between PMN bactericidal rates and clinical outcomes following surgery.
Conclusions:
- Surgical debridement and teicoplanin do not enhance the impaired PMN function in burn patients.
- PMN dysfunction post-burn injury persists despite surgical intervention and antibiotic prophylaxis.
- Current interventions do not restore adequate PMN bactericidal capacity to influence clinical outcomes in this patient group.