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2012 | 84 | 1 | 6-16
Tytuł artykułu

The Impact of the Types of Microorganisms Isolated from Blood and Wounds on the Results of Treatment in Burn Patients with Sepsis

Treść / Zawartość
Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
Despite development of combustiology, infections continue to be the most important cause of death among patients with burns. Sepsis is the most severe clinical presentation of infection in patients after thermal injuries who require immediate treatment. Early diagnosis and proper treatment of sepsis are important in the clinical management that is often hampered for multiple reasons, e.g. impaired patient immunity, problems with microorganisms with multi-antibacterial drug resistance.The aim of the study was to assess effect of type of a microorganism isolated from blood and wound on results of treatment of sepsis in patients with burns.Material and methods. Effect of type of microorganisms isolated from blood and wound on the result of treatment of sepsis was studied in 338 patients hospitalized immediately after an injury in Centre for Burn Treatment in Siemianowice Śląskie in years 2003 - 2004 (at the age of 18 - 96 years, 66 women and 272 men). Clinical symptoms of generalized infection were found in all study subjects. The study group was divided into two subgroups: cured patients and patients who died of sepsis. The following parameters were assessed in both subgroups: type of microorganism isolated from blood, type of microorganism isolated from wound as well as occurrence of the same and different infections of blood and burn wound.Results. positive blood cultures were found in 165 patients (48.8%), 106 (64.2%) were cured, 59 (35.8%) died. The most commonly isolated microorganisms in cured patients were Gram(+) Staphylococcus epidermidis MRSE (19.81%) and Staphylococcus aureus MRSA (18.87%). Gram(-) intestinal rods were least commonly isolated from this group. The most commonly isolated microorganisms from blood of patients who were to die, included non-fermenting Gram(-) rods Acinetobacter baumannii (35.59%) and Pseudomonas aeruginosa (22.03%). Mixed bacterial flora was found in the blood of 22.03% patients. Among patients who were to die, the same microorganisms were found in the blood and in the wound in 32.2% of patients, while this rate was 17.92 in cured patients. The most commonly found bacteria in the blood and burn wound in the cured patients included Staphylococcus aureus MRSA (31.58%) and Staphylococcus aureus (21.05%). In the group of patients who were to die, the most common bacteria isolated simultaneously from the blood and burn wound included Acinetobacter baumannii (47.37%) and Pseudomonas aeruginosa (36.84%).Conclusions. 1. The patients with thermal injuries are at higher risk of death in the event of sepsis caused by Gram(-) bacteria versus Gram(+) bacteria. 2. Infection of blood and burn wound caused by the same bacteria Pseudomonas aeruginosa and Acinetobacter baumanni increases the risk of death due to sepsis in patients with burns following thermal injuries.
Słowa kluczowe
Wydawca

Rocznik
Tom
84
Numer
1
Strony
6-16
Opis fizyczny
Daty
wydano
2012-01-01
online
2012-04-03
Twórcy
autor
  • Faculty of Physiotherapy, Medical University of Silesia in Katowice
  • Centre for Burns Treatment in Siemianowice Śląskie
Bibliografia
  • Pruitt B: The diagnosis and treatment of infection in the burned patient. Burns 1984;11: 79-91.[Crossref]
  • Murray P, Finegold SM: Anaerobes in burn - wound infection. Rev Infect Dis 1984; 6: 184-86.[Crossref]
  • Karpel E: Zakażenia krwi i zakażenia uogólnione. Zakażenia 2002; 1-2.
  • Balk RA: Sever sepsis and septic shock. Definitions, epidemiology and clinical manifestation. Crit Care Med 2000; 16: 179-92.
  • Reis J, Grzybowski J: Definicje zakażeń szpitalnych. Zakażenia 1997; 1: 20-32.
  • Duszyńska W: Monitorowanie kliniczne zakażeń szpitalnych. Wrocław. Urban & Partner; 2000, str. 32-46.
  • Llewylyn M, Cohen J: Diagnosis of infection In sepsis. Inten Care Med 2001; 27: 10-32.
  • Gospodarek E: Zakażenia krwi - strategie diagnostyczne. Magazyn Medyczny 2002; 8: 24-32.
  • Mylotte JM, Tayara A: Blood cultures: clinical aspects and controversies. Eur J Clin Microbiol Infect Dis 2000; 19: 157-63.[Crossref][PubMed]
  • Łopaciuk U, Dzierżanowska D: Bakteryjne zakażenia krwi - współczesne poglądy na etiologię, rozpoznawanie i leczenie. Kompendium Medycyny 2001; 1: 11-21.
  • Kollef MH, Shermann G, Wards S et al.: Inadeqauate antimicrobial treatment of infections: A risk factor to hospital mortality among critically ill patients. Chest 1999; 115: 462-74.[Crossref]
  • Ibrahim E, Shermann G, Wards S et al.: The influence of inadequate antimicrobial treatment of bloodstream infections an patients outcomes in the ICU setting. Chest 2000; 118: 146-55.[Crossref]
  • Legne M, Bourgoin A, Combon S et al.: Empirical antimicrobial therapy of septic shock patients: Adequacy and impact on the outcome. Crit Care Med 2003; 31: 462-67.
  • Weigand MA, Bardenheuer HJ, Boettiger BW: Klinisches Management bei Patienten mit sepsis. Anaesthesist 2003; 52: 3-22.[Crossref]
  • Bochud PY, Glauser MP, Calandra T: Antibiotics inn sepsis. Intensive Care Med 2001; 10: 43-56.
  • Glik J, Kawecki M, Ziółkowski i wsp.: Czynniki etiologiczne zakażeń krwi u chorych po urazie termicznym. Zakażenia 2005; 2: 99-102.
  • Grzybowski J: Biologia rany oparzeniowej. Bielsko-Biała: α-medica - press; 2001.
  • Reid AS: Biofilms in infections disease and on medical devices. Int J Antimicrob Agents 2003; 22: 223-26.
  • Gang RK, Bang RL, Sanyal SC et al.: Pseudomonas aeruginosa septicaemia in burns. Burns 1999; 25: 611-16.[Crossref]
  • Appelgren P, Björnhagen V, Bragderyd K et al.: A prospective study of infections in burn patients. Burns 2002; 28: 39-46.[Crossref]
  • Lari AR, Alaghehbandan R: Nosocomial infections in an Iranian burn care center. Burns 2000; 26: 737-40.[Crossref]
  • Bang LR, Sharma PN, Sanyal SC et al.: Septicaemia after burn injury: a comparative study. Burns 2002; 28: 746-51.[Crossref]
  • Ferreira AC, Gobara S, Costa SF et al.: Emergence of resistance in Pseudomonas aeruginosa and Acinetobacter species after the use of antimicrobials for burned patients. Inf Control and Hosp Epidemiolog 2004; 25: 868-72.
  • Glik J. Kawecki M, Nowak M i wsp.: Ocena skuteczności zastosowania Zyvoxidu w przypadku zakażeń krwi, tkanej miękkich miękkich i kości u chorych oparzonych. Zakażenia 2006; 6: 131-36.
  • Lesseva MI, Hadjiiski OG: Staphylococcal infections in the Sofia Burn Center Bulgaria. Burns 1996; 22: 279-82.[Crossref][PubMed]
  • Taylor GD, Kibsey P, Kirkland T et al.: Pre-dominance of staphylococcal organism in infections occurring in a burn intensive care unit. Burns 1992; 18: 332-35.[Crossref]
  • Phillips LG, Heggers JP, Robron MC: Burn and trauma units as sources of methicillin resistant Staphylococcus aureus. J Burn Care Rehabil 1992; 13: 293-97.[Crossref][PubMed]
  • Mokaddas EMA, Mustafa AS, Sanyal SC: The prevalence, antibiotic and plasmid profiles of methicillin resistant Staphylococcus aureus (MRSA) in the burns unit of Kuwaiti hospital. J Kuwait Med Assoc 1996; 28: 435-39.
  • Heggers JP, Phillips LG, Boertman JA et al.: The epidemiology of methicillin resistant Staphylococcus aureus in a burn center. J Burn Care Rehabil 1988; 9: 610-12.[Crossref]
  • Pruitt BA, Lindenberg RB, McManus WF et al.: Current approach to prevention and treatment of Pseudomonas aeruginosa infections in burned patients. Rev Infect Dis 1983; 5: 889-97.[Crossref]
  • Rastegar L, Bahrami Honar H, Alaghehbandan R: Pseudomonas infections in Tohid Burn Center, Iran. Burns 1998; 24: 637-41.[Crossref]
  • Flick MR, Cluff LE: Pseudomonas bacteremia: review of 108 cases. Am J Med 1976; 60: 501-08.[PubMed][Crossref]
  • Kreger BE, Craven DE, Carling PC et al.: Gram-negative bacteremia. Reassessment of etiology, epidemiology and ecology in 612 patients. Am J Med 1980; 68: 332-55.[Crossref]
  • Bayat A, Shaaban H, Dodgson A et al.: Implications for Burns Unit desing following outbreak of multi- resistant Acinetobacter infection in ICU and Burns Unit. Burns 2003; 29(4): 303-06.[Crossref]
  • Simor AE, Lee M, Vearncombe M et al.: An outbreak due to multiresistant Acinetobacter bumannii in a burn unit: risk factors for acquisition and management. Infect Control Hosp Epidemiol 2002; 23 (5): 261-67.
  • Sengupta S, Kumar P, Ciraj AM et al.: Acinetobacter baumannii -an emerging nosocomial pathogen in the burns unit Manpal, India. Burns 2001; 27 (2): 140-44.[Crossref]
  • Paavilainen T, Alanen M, Makela M et al.: Infrequent isolation of multiresistant Acinetobacter baumannii from the staff tending a colonized patient with severe burns. Infect Control Hosp Epidemiol 2001; 22(6): 388-91.
  • Rumbaugh KP, Griswold JA, Iglewski BH et al.: Contribution of Quorum sensing to role the virulence of Pseudomonas aeruginosa in burn wound infections. Infect and Immunity 1999: 67; 5854-62.
  • Łyczak JB, Cannon CL, Pier GB: Establishment of Pseudomonas aeruginosa infection: lessons from a versatile opportunist. Microb An Infections 2000; 2: 1051-60.
  • Church D, Elsayed S, Reid O et al.: Burn wound infections. Clin Microb Reviews 2006; 19: 403-34.[Crossref]
  • Rumbaugh KP, Griswold JA, Hammod AN: The role of Quorum sensing in the in vivo virulence of Pseudomonas aeruginosa. Microb An Infections 2000; 2: 1.
Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.-psjd-doi-10_2478_v10035-012-0002-7
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