Skip to main content
SpringerLink
Log in

Infection and Sepsis

  • Chapter
  • First Online:
Burn Care for General Surgeons and General Practitioners

Abstract

In this chapter, we address the battle between host and microbe in the burn patient. A multiplicity of infection types is discussed, including ventilator-associated pneumonia, central line infection, UTI, and burn wound infection. The paradigm of treatment for these infections is explained, as well as specific pathogens of concern and the agents of their coverage in modern practice. Sepsis, defined differently in the burn patient, is discussed along with the reasons behind this difference.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Bessey PQ, Phillips BD, Lentz CW, Edelman LS, Faraklas I, Finocchiaro MA, et al. Synopsis of the 2013 annual report of the national burn repository. J Burn Care Res. 2014;35 Suppl 2:S218–34.

    Article  PubMed  Google Scholar 

  2. Greenhalgh DG, Saffle JR, Holmes 4th JH, Gamelli RL, Palmieri TL, Horton JW, et al. American Burn Association consensus conference to define sepsis and infection in burns. J Burn Care Res. 2007;28(6):776–90.

    Article  PubMed  Google Scholar 

  3. Ani C, Farshidpanah S, Bellinghausen Stewart A, Nguyen HB. Variations in organism-specific severe sepsis mortality in the United States: 1999-2008. Crit Care Med. 2015;43(1):65–77.

    Article  PubMed  Google Scholar 

  4. Weber DJ, van Duin D, DiBiase LM, Hultman CS, Jones SW, Lachiewicz AM, et al. Healthcare-associated infections among patients in a large burn intensive care unit: incidence and pathogens, 2008-2012. Infect Control Hosp Epidemiol. 2014;35(10):1304–6.

    Article  PubMed  Google Scholar 

  5. Barbier F, Andremont A, Wolff M, Bouadma L. Hospital-acquired pneumonia and ventilator-associated pneumonia: recent advances in epidemiology and management. Curr Opin Pulm Med. 2013;19(3):216–28.

    Article  PubMed  Google Scholar 

  6. Mosier MJ, Gamelli RL, Halerz MM, Silver G. Microbial contamination in burn patients undergoing urgent intubation as part of their early airway management. J Burn Care Res. 2008;29(2):304–10.

    Article  PubMed  Google Scholar 

  7. Luna CM, Bledel I, Raimondi A. The role of surveillance cultures in guiding ventilator-associated pneumonia therapy. Curr Opin Infect Dis. 2014;27(2):184–93.

    Article  PubMed  Google Scholar 

  8. Diaz E, Munoz E, Agbaht K, Rello J. Management of ventilator-associated pneumonia caused by multiresistant bacteria. Curr Opin Crit Care. 2007;13(1):45–50.

    Article  PubMed  Google Scholar 

  9. Karaiskos I, Giamarellou H. Multidrug-resistant and extensively drug-resistant Gram-negative pathogens: current and emerging therapeutic approaches. Expert Opin Pharmacother. 2014;15(10):1351–70.

    Article  CAS  PubMed  Google Scholar 

  10. Goutier JM, Holzmueller CG, Edwards KC, Klompas M, Speck K, Berenholtz SM. Strategies to enhance adoption of ventilator-associated pneumonia prevention interventions: a systematic literature review. Infect Control Hosp Epidemiol. 2014;35(8):998–1005.

    Article  PubMed  Google Scholar 

  11. Townsend CM, Beauchamp RD, Evers BM, Mattox KL, editors. Sabiston textbook of surgery: the biological basis of modern surgical practice. 19th ed. Philadelphia, PA: Elsevier Saunders; 2012.

    Google Scholar 

  12. O'Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, et al. Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis. 2011;52(9):e162–93.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Pronovost P. Interventions to decrease catheter-related bloodstream infections in the ICU: the Keystone Intensive Care Unit Project. Am J Infect Control. 2008;36(10):S171.e1–5.

    Article  Google Scholar 

  14. Miller RS, Norris PR, Jenkins JM, Talbot 3rd TR, Starmer JM, Hutchison SA, et al. Systems initiatives reduce healthcare-associated infections: a study of 22,928 device days in a single trauma unit. J Trauma. 2010;68(1):23–31.

    Article  PubMed  Google Scholar 

  15. Venable A, Dissanaike S. Is automated electronic surveillance for healthcare-associated infections accurate in the burn unit? J Burn Care Res. 2013;34(6):591–7.

    Article  PubMed  Google Scholar 

  16. Kagan RJ, Neely AN, Rieman MT, Hardy A, Warner P, Bailey JK, et al. A performance improvement initiative to determine the impact of increasing the time interval between changing centrally placed intravascular catheters. J Burn Care Res. 2014;35(2):143–7.

    Article  PubMed  Google Scholar 

  17. Sacks GD, Diggs BS, Hadjizacharia P, Green D, Salim A, Malinoski DJ. Reducing the rate of catheter-associated bloodstream infections in a surgical intensive care unit using the Institute for Healthcare Improvement Central Line Bundle. Am J Surg. 2014;207(6):817–23.

    Article  PubMed  Google Scholar 

  18. Ungureanu M. Concepts in local treatment of extensive paediatric burns. J Med Life. 2014;7(2):183–91.

    CAS  PubMed  PubMed Central  Google Scholar 

  19. Storm-Versloot MN, Vos CG, Ubbink DT, Vermeulen H. Topical silver for preventing wound infection. Cochrane Database Syst Rev. 2010;3:CD006478.

    PubMed  Google Scholar 

  20. Barajas-Nava LA, Lopez-Alcalde J, Roque i Figuls M, Sola I, Bonfill Cosp X. Antibiotic prophylaxis for preventing burn wound infection. Cochrane Database Syst Rev. 2013;6:CD008738.

    PubMed  Google Scholar 

  21. Paul M, Benuri-Silbiger I, Soares-Weiser K, Leibovici L. Beta lactam monotherapy versus beta lactam-aminoglycoside combination therapy for sepsis in immunocompetent patients: systematic review and meta-analysis of randomised trials. BMJ. 2004;328(7441):668.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Kim S, Lieberman TD, Kishony R. Alternating antibiotic treatments constrain evolutionary paths to multidrug resistance. Proc Natl Acad Sci U S A. 2014;111(40):14494–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Housinger TA, Brinkerhoff C, Warden GD. The relationship between platelet count, sepsis, and survival in pediatric burn patients. Arch Surg. 1993;128(1):65–6. discussion 66–7.

    Article  CAS  PubMed  Google Scholar 

  24. Wolf SE, Jeschke MG, Rose JK, Desai MH, Herndon DN. Enteral feeding intolerance: an indicator of sepsis-associated mortality in burned children. Arch Surg. 1997;132(12):1310–3. discussion 1313–4.

    Article  CAS  PubMed  Google Scholar 

  25. Dellinger RP, Carlet JM, Masur H, Gerlach H, Calandra T, Cohen J, et al. Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock. Crit Care Med. 2004;32(3):858–73.

    Article  PubMed  Google Scholar 

  26. Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med. 2013;39(2):165–228.

    Article  CAS  PubMed  Google Scholar 

  27. Harrison DA, Welch CA, Eddleston JM. The epidemiology of severe sepsis in England, Wales and Northern Ireland, 1996 to 2004: secondary analysis of a high quality clinical database, the ICNARC Case Mix Programme Database. Crit Care. 2006;10(2):R42.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Vazquez-Guillamet C, Scolari M, Zilberberg MD, Shorr AF, Micek ST, Kollef M. Using the number needed to treat to assess appropriate antimicrobial therapy as a determinant of outcome in severe sepsis and septic shock. Crit Care Med. 2014;42(11):2342–9.

    Article  CAS  PubMed  Google Scholar 

  29. Herndon DN. Total burn care. 4th ed. Philadelphia, PA: Elsevier Saunders; 2012.

    Google Scholar 

  30. Mann EA, Wood GL, Wade CE. Use of procalcitonin for the detection of sepsis in the critically ill burn patient: a systematic review of the literature. Burns. 2011;37(4):549–58.

    Article  PubMed  Google Scholar 

  31. Barati M, Alinejad F, Bahar MA, Tabrisi MS, Shamshiri AR, Bodouhi NO, et al. Comparison of WBC, ESR, CRP and PCT serum levels in septic and non-septic burn cases. Burns. 2008;34(6):770–4.

    Article  PubMed  Google Scholar 

  32. Lavrentieva A, Papadopoulou S, Kioumis J, Kaimakamis E, Bitzani M. PCT as a diagnostic and prognostic tool in burn patients. Whether time course has a role in monitoring sepsis treatment. Burns. 2012;38(3):356–63.

    Article  CAS  PubMed  Google Scholar 

  33. Paratz JD, Lipman J, Boots RJ, Muller MJ, Paterson DL. A new marker of sepsis post burn injury?*. Crit Care Med. 2014;42(9):2029–36.

    Article  CAS  PubMed  Google Scholar 

  34. Bargues L, Chancerelle Y, Catineau J, Jault P, Carsin H. Evaluation of serum procalcitonin concentration in the ICU following severe burn. Burns. 2007;33(7):860–4.

    Article  CAS  PubMed  Google Scholar 

  35. Jeschke MG, Finnerty CC, Kulp GA, Kraft R, Herndon DN. Can we use C-reactive protein levels to predict severe infection or sepsis in severely burned patients? Int J Burns Trauma. 2013;3(3):137–43.

    CAS  PubMed  PubMed Central  Google Scholar 

  36. Rousseau AF, Layios N. Serum markers of sepsis in burn patients: it takes more to convince! Crit Care Med. 2015;43(3):e100–1.

    Article  PubMed  Google Scholar 

  37. Honore PM, Jacobs R, De Waele E, Spapen HD. Biomarkers to detect sepsis: a “burning” issue but still a long way to go*. Crit Care Med. 2014;42(9):2137–8.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Texas Tech University Health Sciences Center, 3601 4th Street STOP 8312, Lubbock, TX, 79430-8312, USA

    Sharmila Dissanaike M.D., F.A.C.S., Samantha A. Moore M.D., Ph.D. & Derek Yang B.S.

Authors
  1. Sharmila Dissanaike M.D., F.A.C.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Samantha A. Moore M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Derek Yang B.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sharmila Dissanaike M.D., F.A.C.S. .

Editor information

Editors and Affiliations

  1. Univ. of California, Davis Med. Center, Shriners Hosp for Children N California, Sacramento, California, USA

    David G. Greenhalgh

Common Multidrug-Resistant Organisms in Burn Infections

Common Multidrug-Resistant Organisms in Burn Infections

Acinetobacter baumanii

Pseudomonas aeruginosa

Klebsiella pneumoniae

Methicillin-resistant Staphylococcus aureus (MRSA)

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Dissanaike, S., Moore, S.A., Yang, D. (2016). Infection and Sepsis. In: Greenhalgh, D. (eds) Burn Care for General Surgeons and General Practitioners . Springer, Cham. https://doi.org/10.1007/978-3-319-29161-1_7

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-29161-1_7

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-29159-8

  • Online ISBN: 978-3-319-29161-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation