Burn infections characteristics: A review

Abstract

Burn injuries are unique in comparison to other types of trauma because of their severity and major systemic impact produced by extensive lesions with disfunctions that can persist even several years after the injury. Multiple complications can occur during burn injury evolution, from which infections are the most severe and the most frequently encountered, requiring adequate diagnosis and treatment. In most burn centers, increased mortality rates associate with severe burn injuries aggravated by the development of sepsis. There are multiple sources of infections in burned patients: lungs, wounds, catheters, gastrointestinal and urinary tract. Pathogens are often multi-resistant bacteria but also fungi and viruses appear as opportunistic infections. The main goal is represented by prevention of organ dysfunction development through specific supportive measures that avoid its onset. Early excision of the burn eschar and wound grafting is essential for patient outcome, decreasing duration of hospitalization, infectious risk and mortality. As a principle, antibiotic treatment in burn infectious complications is started empirically, with broad spectrum agents if the results of microbiological cultures are not available and immediately after the antibiogram is available, targeted antibiotic is introduced. De-escalation strategy is promoted in order to prevent antimicrobial resistance: narrow spectrum drugs with proven efficacy on determined germs are administered, avoiding if possible, reserve antibiotics.

Multidrug-Resistant Pathogens in Burn Wound, Prevention, Diagnosis, and Therapeutic Approaches (Conventional Antimicrobials and Nanoparticles)

“…Infection. Surgical wound infections occur in incised wounds and donor tissues that are not-epithelialized [39]. Te wound secretes pus which makes wound culture positive [39].…”

“…Burn wound cellulitis includes at least one of the following signs: swelling or heat, pain, or local sensitivity in the affected area, progressive erythema, or edema, as well as symptoms of lymphadenitis, which spread from the injured skin along the lymphatic pathways [ 37 ]. Bacteremia and septicemia can also be symptoms of burn wound cellulitis [ 37 , 39 ].…”

“…Surgical wound infections occur in incised wounds and donor tissues that are not-epithelialized [ 39 ]. The wound secretes pus which makes wound culture positive [ 39 ]. Also, appearance changes that include erythema and hyperemia of healthy skin around the wound include the features of surgical burn infection [ 39 ].…”

“…The wound secretes pus which makes wound culture positive [ 39 ]. Also, appearance changes that include erythema and hyperemia of healthy skin around the wound include the features of surgical burn infection [ 39 ].…”

“…In addition, isolation of pathogens from blood culture in the absence of other identifiable sources of infection, signs of systemic septicemia (such as tachycardia, hypotension, oliguria, and hyperglycemia), and evidence of microbial invasion of the underlying tissues on histopathological examination are other symptoms of this type of burn wound infections [ 34 , 37 ]. The most common pathogens that are related to unexcised burn invasive infection include P. aeruginosa , S. aureus , A. baumannii , and Enterobacteriaceae [ 39 , 40 ].…”