Editorial: Feeling the burn: sphingolipids and infection risk after thermal injury

Extract

Infection is a leading cause of morbidity and mortality in severely burned patients [1, 2]. Loss of the protective skin barrier, altered antimicrobial immunity, and the use of invasive devices, such as central venous catheters and endotracheal tubes, to support vital physiologic functions predispose critically ill burn patients to serious infections. The problem is worsened by the increasing incidence of infection with antibiotic-resistant bacteria [1, 3, 4]. Investigators at the Shriners Hospital for Children in Galveston determined that 73% of septic burn patients were infected with antibiotic-resistant organisms, and 47% of postburn mortality was a result of sepsis. Pseudomonas aeruginosa is a common nosocomial pathogen in burn victims, as a result of its propensity for infecting subjects with impaired immune function and predilection for developing antibiotic resistance [1]. In a study by Williams et al. [1], P. aeruginosa was responsible for 64% of deaths caused by antibiotic-resistant bacteria in their cohort of severely burned children. Nevertheless, the mechanisms that predispose severely burned patients to infection remain unclear. Thus, there is a need to understand why burned patients are susceptible to infection and develop new strategies to prevent and treat infection in these vulnerable patients.