Infection continues to be the major cause of death in patients who have been severely burned although the spectrum of pathogenic bacteria responsible for the death of burned patients has undergone a definite metamorphosis.1 Prior to the discovery and use of penicillin, streptococcal infections accounted for a large number of infectious deaths. Staphylococcus aureus became the predominant cause of postburn septic deaths with the emergence of penicillin-resistant strains. In more recent years, the Staphylococcus has been controlled by penicillinase-resistant antibiotics, and infections with gram-negative organisms, especially Pseudomonas aeruginosa, have become increasingly prevalent. Most of these infections can be controlled by appropriate systemic and topical antimicrobial therapy, but sepsis from P aeruginosa continues to be a major problem in most burn centers. Well-established Pseudomonas sepsis in patients with large burns has been exceedingly difficult to control by any treatment regimen, and the vast majority of these patients fail to survive.
Alexander JW, Fisher MW, MacMillan BG, Altemeier WA. Prevention of Invasive Pseudomonas Infection in Burns With a New Vaccine. Arch Surg. 1969;99(2):249–256. doi:10.1001/archsurg.1969.01340140121018