title: The importance of early diagnosis of sepsis in severe burned patients: outcomes of 100 patients.
abstract: OBJECTIVE
  The burn-injured patient has a major potential to develop an infection because the wound itself, surgical treatment, mechanical ventilation and blood transfusions may potentially lead to a secondary immunodeficiency syndrome.
  
  
  METHODS
  A total number of 100 consecutive burn-injured patients with sepsis were treated in the Clinical Emergency Hospital of Plastic Surgery and Burns, Bucharest,between 2009 and 2011. Their clinical and bioumoral data were analyzed.
  
  
  RESULTS
  Flame was the main cause of burn injuries in the present series (78%). The mean body surface area burn wound was 49.7%. Most of the patients (97%) experienced the first septic episode within two weeks after burn injury.Sepsis was mainly due to Gram-positive (58%) and Gramnegative(26%) bacteria. Staphylococcus aureus (32%) and Pseudomonas aeruginosa (21%) were the most frequently encountered germs. The susceptibility for Gram-positive bacteria was the best for imipenem/cilastatin, followed byamikacin, ceftriaxone and ciprofloxacin. For Gram-negative bacteria, the susceptibility decreased from ciprofloxacin to imipenem/ cilastatin, amikacin and gentamicin. Mortality rate was 9%.
  
  
  CONCLUSIONS
  The extensive knowledge of physiopathology,clinics, epidemiology, bioumoral and microbiology features of the sepsis in burn-injured patients allows an early and precise diagnosis and an adequate and efficient treatment.All these elements have been associated with a significant improvement of the survival rates. Every patient with burn injured sepsis must be treated as a different entity in order to obtain the best results.
authors.affiliation: Fundeni Clinical Institute, Bucharest, Romania. orbancarmen@yahoo.com
authors.forename: C
authors.initials: C
authors.lastname: Orban
authors.forename: D
authors.initials: D
authors.lastname: Tomescu
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality / Q000628:therapy; D002053:Burn Units / Q000706:statistics & numerical data; D002056:Burns / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D024881:Drug Resistance, Bacterial; D004359:Drug Therapy, Combination; D042241:Early Diagnosis; D004636:Emergency Service, Hospital; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D016908:Gram-Positive Bacterial Infections / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D006785:Hospitals, University; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D008297:Male; D008826:Microbial Sensitivity Tests; D011379:Prognosis; D012383:Romania / Q000453:epidemiology; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents