P. aeruginosa Burn Infections: Pathogenesis and Treatment
Abstract
Prior to the late 1950s burn deaths related to infection were caused by the gram-positive bacteria Staphylococcus aureus and Streptococcus pneumoniae.1,2 Improved methods of fluid therapy introduced between 1950 and 1960 allowed survival of many severely burned patients over the initial period of thermal injury; this increased survival time coupled with the introduction of antibiotics capable of controlling gram-positive sepsis caused a shift in septic complications to those caused by gram-negative bacteria.3–5 Infections caused by Pseudomonas aeruginosa were particularly severe, with high mortality rates.6 In the intervening years, P. aeruginosa continued to cause the most severe, life-threatening infections in burn patients, in spite of the introduction of a wide variety of antibiotics devised specifically for their antipseudomonal activity. One U.S. burn institution reported that from 1959 to 1983, mortality from P. aeruginosa infection was 77%; this was 28% higher than the mortality predicted on the basis of severity of injury in the infected patients.? Another burn unit reported that between 1969 and 1988, while percent recovery of Escherichia coli and Klebsiella—Enterobacter from the wounds of burn patients was similar to that of P. aeruginosa, P. aeruginosa caused more fatal septicemia than the combined deaths from all other gram-negative bacteria.8 The mortality figures cited in these studies point out the unique host: parasite interaction that is present in P. aeruginosa infection in burned individuals.
Keywords
Pseudomonas Aeruginosa Burned Site Burned Patient Silver Sulfadiazine Hageman FactorPreview
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References
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