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SEPTICEMIA IN BURNED PATIENTS *
Author(s) -
Balch Henry H.
Publication year - 1968
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/j.1749-6632.1968.tb14751.x
Subject(s) - bacteremia , staphylococcus aureus , microbiology and biotechnology , bacteria , pathogenic bacteria , medicine , phagocytosis , antibiotics , immunology , biology , genetics
Summary The purpose of the present investigation was to determine whether severely burned patients were more susceptible to invasive infection because of an associated impairment of the natural antibacterial defense systems. 1. Leucocyte plasma and plasma bactericidal effect against Staphylococcus aureus (phagetype 80/81) is significantly increased in severely burned patients. 2. The cellular reaction to peripheral injury is depressed for several days in severely burned patients. 3. Several factors determine the balance between bacterial invasion and host resistance and these are continually shifting. With Staphylococcus aureus (phagetype 80/81), tissue and blood stream invasion is more likely when the initial high post‐trauma bactericidal effect has returned to normal levels. 4. The primary cause of bacteremia in burned patients is the presence of a high bacteria cell ratio in the wound, especially if the microorganisms are pathogenic. However, continual bacteremia by pathogenic bacteria can cause septicemia in burned and nonburned patients. Septicemia is a common complication of severely burned patients. Our studies of host resistance in eight such patients have shown that the blood bactericidal effect against pathogenic bacteria was better than normal in the early post‐burn days while the cellular response to peripheral injury was depressed. Nevertheless, migrating polymorphonuclear cells retained an excellent capacity for phagocytosis. Several factors determine the balance between bacterial invasion and host resistance and these are continually shifting. The primary cause of bacteremia in burned patients probably is the presence of a high bacteria‐cell ratio in the wound, especially if the microorganisms are pathogenic. Such continual bacteremia by pathogenic bacteria can cause septicemia in burned (and non‐burned) patients.