Infections caused by Pseudomonas species in patients with burns and in other surgical patients

Infections caused by Pseudomonas species are a particular threat to all patients with extensive burns, as well as to other critically ill surgical patients. These gramnegative opportunistic bacteria proliferate rapidly in and invade through nonviable tissue such as the burn wound. Topical chemotherapy with Sulfamylonburn creams has significantly reduced the occurrence of pseudomonas burn wound sepsis, but wound surveillance and biopsy monitoring are essential to the assessment of the bacterial density of the burn and to the timely alteration of therapy. Pseudomonas infections of the lung may be either hematogenous or airborne in origin, and the clinical course and treatment vary accordingly. Pseudomonas suppurative thrombophlebitis may also occur in patients with impaired antimicrobial defenses and may serve as a source of systemic dissemination. With improved treatment and prophylaxis of pseudomonas infections, other opportunistic microorganisms that are even more difficult to treat have emerged. This phenomenon emphasizes that immunologic enfeeblement is the basic problem to be addressed.