OBJECTIVETo investigate the pathogenesis, management and prognosis of severe burn patients with sepsis during shock stage.

METHODSFourty-four patients inflicted with over 60% TBSA burn injury and admitted to our hospital within 48 hours after injury during the past 8 years were enrolled in the study. The application of antibiotics in this group of patients was analyzed. The incidence of burn sepsis during shock stage in this group was calculated according to the results of the bacterial culture of the blood samples and burn wound samples,as well as the diagnostic criteria of sepsis. The relationship between sepsis during shock stage and the possibility of enteral bacterial translocation was discussed. Other postburn complications in patients with burn sepsis during shock stage were also observed and their prognosis was explored.

RESULTSThis group of patients were all treated with 3rd and 4th generation of Cephalosporins and Imipenem/Cilastatin sodium after hospitalization. Burn sepsis during shock stage occurred in 4 cases (9.09%), in which one was caused by Pseudomonas aeruginosa and other three possibly by Escherichia coli, Streptococcus faecalis and Bacillus gasoformans. Among the 4 cases, severe disorder in water and electrolytes happened in 1 case, stress ulcer in 2 and acute renal failure in 2. As a result, only one out of the 4 patients survived.

CONCLUSIONBacterial translocation was probable cause of sepsis during shock stage. Shock might predispose sepsis. Early postburn applications of antibiotics sensitive to enteric bacteria could be beneficial to the management of burn sepsis during shock stage.