Infection of cutaneous lesions caused by burns

Abstract

The infections of the cutaneous lesions caused by burns re­pre­sent one of the most frequent causes of mortality and mor­bi­dity in burned patients, being an important public health issue. The thermal destruction of the cutaneous bar­rier and the local and systemic immune depression of the host are essential factors that contribute to the onset of infection in severely burned patients. Depending on the ex­tent of the burned lesions, on the concentration of the pa­th­o­ge­nic organisms that colonize the wound and on their pe­ne­tra­tion over and in the depth of the viable sub­cu­ta­neous tis­sue (not burnt), we can define dif­fe­rent types of in­fec­tions, from the wound colonization to the noninvasive and the in­va­sive infections (cellulitis, necrotizing fasciitis). When the mi­cro­or­ga­nisms invade the bloodstream, they can cause sep­ti­cae­mia, which is an important mortality factor. The burn wounds are contaminated most often by bac­te­ria and fungi, among which the most frequent species are Sta­phy­l­o­coccus aureus, Pseudomonas aeruginosa and, la­te­ly, Aci­ne­tobacter baumannii and Klebsiella pneumoniae; the fun­gal infections represent a mortality predictor in pa­tients with burns on more than 30-60% of the body’s surface area. The pathogenic agents may originate from the host’s nor­mal flora (gastrointestinal and of the upper respiratory tract) and/or from the hospital environment. The emergence of the an­ti­microbial resistance, especially to nosocomial bac­te­rial iso­lates, is an important obstacle in the treatment of these in­fec­tions. Therefore, it is vital to know the micro­or­ga­nisms most frequently involved in the infections of the burn wounds, and their susceptibility to antibiotics.