Enterococcal burn sepsis. A highly lethal complication in severely burned patients
W. G. Jones, P. S. Barie, R. W. Yurt and C. W. Goodwin
A retrospective study was undertaken to examine the incidence and clinical
significance of enterococcal bacteremia in burned patients with
enterococcal burn-wound infections. During a 26-month period from 1983 to
1985, 38 patients were found to have enterococcal burn-wound infections.
Twenty of these patients developed positive blood cultures for enterococcus
with no other identifiable source for the bacteremia. Cases occurred
sporadically during the study period without evidence of a specific
epidemic. Ten patients died within ten days of the bacteremia, while nine
others eventually died from other complications. Only one patient survived
to discharge. Prior antibiotic therapy did not appear to increase the risk
for enterococcal infection, and specific therapy against the enterococcus
after the bacteremia was identified appeared to have no effect on
mortality. Mortality was significantly greater for bacteremic patients than
for patients with enterococcal wound infection alone or for burned patients
without enterococcal infections. Although previously not considered
pathogenic, enterococcal burn-wound infections should prompt aggressive
therapy to prevent the development of enterococcal sepsis with its
associated high mortality.
