Active Immunization against Pseudomonas aeruginosa in Burns
Although during the last few years, the incidence of septicemia as a complication in full-thickness burns has been reduced, it is not yet possible to avoid it completely. The percentage of patients who still die during the course of infection requires the study of this problem intensively from the clinical and bacteriological points of view. It has to be pointed out that all measures to keep the burn surface free of pathogenic bacteria are not successful. It is possible, however, to reduce the number of bacteria by the so-called topic treatment. In general, primarily gram-negative bacteria are involved. In contrast to the increasing number of cases of infection with Klebsiella and Candida reported in the United States, we have observed predominant infections with Pseudomonas aeruginosa following extensive third degree burns. Before submitting our patients to an active immunization program similar to that of Feller (1), we performed an extensive epidemiologic study (3, 4). The reason for this approach was to get information about the frequency and distribution of different strains of Pseudomonas. We used the method according to Lányi (2) by which 13 0-groups can be differentiated. This method was applied in more than 8000 cultures taken from the wounds, the environment, and the in- and outlets of the waterpipes. Tables I and II show the summary of these results obtained in 1972. The most frequent 0-groups isolated from the wounds were groups 5 and 13. A similar prevalence was found in the environment. In contrast, there was a high percentage of 0-group 4 in the water in- and outlets. We conclude that Pseudomonas isolated from the latter contributes to wound infection only to a very minor degree.
KeywordsPseudomonas Aeruginosa Antibody Titer Sterile Culture Endotoxin Action Agglutination Titer
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