Factors Predicting Patient Outcomes in a UK Burn’s Unit; The influence of Acinetobacter Baumannii and the antimicrobial peptide LL-37 in burn wounds..
Abstract
Sepsis and multi-organ failure are the most frequently reported causes of death in
burn injuries. Their early identification allows therapies and resources to be targeted
in a more effective and efficient way. Due to its frequent antibiotic drug resistance
Acinetobacter baumannii (MRAB) is increasingly causing a problem in burns units.
New strategies need to be found to combat infection and sepsis in the burn ICU.
This study examines the potential of the Albumin Creatinine Ratio, a marker of
systemic endothelial dysfunction in predicting outcomes, sepsis and multi-organ
failure; the role of Acinetobacter in causing organ failure; and explores for the
presence of the cathelicidin, LL-37 in the burn wound and examines it potential utility
for treating infection and sepsis.
It was found that ACR on admission and at 48 hours is predictive of patient outcomes
and the development of sepsis, and may be of use predicting multi-organ failure.
Multi-organ failure occurs more frequently in MRAB patients compared to those
patients with drug sensitive Acinetobacter baumannii. The number of agency nursing
staff and work intensity are possible contributing factors in MRAB acquisition. LL-37
has been found in both acute burn wounds as well as in the grafted healing burn
wound and is active against drug resistant Acinetobacter baumannii.
ACR can therefore identify those patients at risk of sepsis and may have a role in
predicting multi-organ failure.
MRAB acquisition in the burns intensive care unit is a significant cause for concern
as patients are more likely to suffer from multi-organ failure as well as prolonging
their hospital stay and resulting in poorer outcomes.
LL-37 has many functions and importantly plays a role in the body’s innate immune
system. In the era of increasing antibiotic resistance it may provide a novel
therapeutic role in treating MRAB infection.
Authors
Collins, DeclanCollections
- Theses [3822]