Infectious Diseases Service, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
The Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
Surg Infect (Larchmt). 2021 Feb;22(1):103-112. doi: 10.1089/sur.2020.129. Epub 2020 May 20.
Infection is the most frequent complication after severe burns and remains the predominant cause of death. Burn patients may require multiple courses of antibiotics, lengthy hospitalizations, and invasive procedures that place burn patients at especially high risk for infections with multi-drug-resistant organisms (MDROs). The published literature on MDROs in burn patients was reviewed to develop a strategy for managing these infections. Within a burn unit meticulous infection prevention and control measures and effective antimicrobial stewardship can limit MDRO propagation and decrease the antibiotic pressure driving the selection of MDROs from less resistant strains. Several new antimicrobial agents have been developed offering potential therapeutic options, but familiarity with their benefits and limitations is required for safe utilization. Successful management of MDRO burn infections is supported by a multifactorial approach. Novel non-antibiotic therapeutics may help combat MDRO infections and outbreaks. Multi-drug-resistant organisms are being identified with increasing frequency in burn patients. Effective sensitivity testing is essential to identify MDROs and to direct appropriate antibiotic choices for patient treatment.
感染是严重烧伤后最常见的并发症，仍然是主要的死亡原因。烧伤患者可能需要多次使用抗生素，住院时间长，并且需要进行侵入性操作，这使烧伤患者特别容易感染多药耐药菌（MDROs）。为了制定管理这些感染的策略，对烧伤患者中 MDRO 的文献进行了回顾。在烧伤病房内，细致的感染预防和控制措施以及有效的抗菌药物管理可以限制 MDRO 的传播，并减少选择耐药程度较低的 MDRO 的抗生素压力。已经开发出几种新的抗菌药物，为治疗提供了潜在的选择，但为了安全使用，需要熟悉其益处和局限性。多因素方法支持 MDRO 烧伤感染的成功管理。新型非抗生素疗法可能有助于对抗 MDRO 感染和爆发。在烧伤患者中，MDRO 的检出率越来越高。有效的药敏试验对于识别 MDRO 并为患者治疗选择合适的抗生素至关重要。
