Immunological and microbiological investigations of patients with burn injuries.

Unlabelled: Susceptibility of patients with burn injuries to infections is associated with disturbances of the humoral and cell-mediated immunity. The aim of the present study was to investigate the dynamics of phagocytic indices and serum immunoglobulin levels in patients with burn injuries as there is a high risk of colonization and infection of the burn wound.

Patients And Methods: Between December 2004 and April 2005, we studied the dynamics of the following indices of the phagocytic system and humoral immunity of 30 burned patients: phagocytic index, phagocytic number, nitro blue tetrazolium chloride test, leukocyte number in the peripheral blood, the percentage of the neutrophilic leukocytes from the differential blood count, serum levels of immunoglobulins A, G and M and the percentage of lymphocytes. In addition, microbiological tests of the wound secretions were performed using conventional microbiological methods.

Results: The changes in the phagocytic indices suggested that it is the decreased phagocytic index and number that are important for the evaluation of wound infection risks. The increased total number of leukocytes and elevation of the neutrophil levels usually observed in burned patients indicate the presence of bacterial infection and the prompt involvement of the phagocytic mechanisms. The lower percentage of lymphocyte in comparison with the healthy controls was indicative also of a possible involvement of the cell-mediated immune response. The characteristic humoral mechanisms of the immune response (serum immunoglobulins) in patients with thermal injuries altered only slightly.

Conclusions: The analyzed data may be of help in evaluating the risk of colonization and infection of the burn wound in patients with burn injuries. We would like to recommend a compulsory battery of microbiological tests and several immunological investigations phagocytic index, phagocytic number, leukocyte number, differential blood test and serum immunoglobulins with a view to applying an adequate antimicrobial and immune modulating treatment.