Pathogenesis of Wound Infections

Abstract

The introduction of antibiotics has caused a decline in surgical infections, and gram-negative organisms replaced Staphylococcus aureus as the major nosocomial pathogen during the 1960s and 1970s in the industrialized world. However, during the last decade we have encountered a revival of S. aureus as a major wound pathogen, partly because of the emergence of multiple antibiotic resistant strains and methicillin-resistant S. aureus (MRSA). In biomaterial-associated infections, i.e., infections in intravascular and intraperitoneal catheters, joint and vascular prostheses, coagulase-negative staphylococci, mainly S. epidermidis, are the most important pathogens [9, 106]. They may also cause wound infections, and multiple antibiotic resistant strains are commonly isolated in hospital environments. In burn wound infections Pseudomonas aeruginosa is well established as a primary pathogen, as is the fungus Candida albicans [33]. Groups A, C and G streptococci have, throughout the decades, been the primary pathogens of different kinds of wound infections.