Modern views on the microflora of burn wounds and its antibiotic resistance

Prognosis of outcome of the burn injury depends on recovery speed of damaged layers of derma, therefore execution of the authodermoplasty stays the main principle of the burn injury treatment. However, local infectious complication retard processes of reparation and epithelization of tissues, hinder the engraftment of the donor skin graft, promote the lasting of healing of the donor wounds. But penetration of pathogenic microflora via damaged skin covers leads to infectious generalization with development of multiple organ failure, sepsis, pneumonia, to the increase of lethal outcome quantity. Considering the role of infection in a structure of mortality of burned patients, the significance to study of its etiology, pathogenesis and treatment does not raise doubts. Opportunistic microflora, causing hospital-acquired, or nosocomial, infections, plays a great role in the development of the similar condition in severely burned patients. Among these representatives are Staphylococcus aureus, Enterococcus faecium, Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii and Enterobacteriaceae spp. The main clinical significant characteristics of such flora are multiresistance to most antimicrobial drugs, high prevalence in hospitals, and the ability to form biofilms on the surface of burn wounds. It should be noted that with every year the trend of antimicrobial resistance is increasing, and the number of resistant strains is also increasing. Therefore, it is getting more difficult to select adequate antibacterial treatment schemes for severe complicated burn injuries. The prescription of empirical therapy for nosocomial infections in burn patients should be based on the results of monitoring the microbial flora and determining its sensitivity to antibacterial drugs. In addition, methods of local treatment of wounds are constantly being improved using special wound dressings with antiseptic solutions and bacteriophage. To improve treatment rates for such patients, it is necessary to evaluate not only the local state of the wound surface, the degree of bacterial contamination of wounds and systemic inflammation during the entire period of hospitalization, but also the state of the epidemiological situation in burn care hospitals.