Is the cutaneous microbiota involved in burn infections?
The cutaneous microbiota of burn victims is disrupted, including in unburned areas of skin, which may make complications more likely in cases of autologous skin grafts.
Burn victims have a high risk of infection (as many as 19% of patients hospitalized in burn treatment centers in France in 2006) and septic shock. Studies by American scientists suggest that the disruption of the microbiota on burned surfaces−but also on unburned skin used for autologous grafts−may be in part responsible. They compared the cutaneous microbiota of 9 people in good health to that of 9 burn victims (with burns covering 35% of the body surface area on average): the composition of the cutaneous microbiota of burn victims presented similar disruptions in grafted skin considered to be healthy than in wounds, particularly an increase in certain taxa (Aeribacillus, Caldalkalibacillus, and Nesterenkonia) and a reduction in others (Corynebacterium, common skin commensals).
Some of these microbial disruptions were correlated with an increased risk of complications. The quantity of bacteria in the genus Corynebacterium increased with a higher risk of wound infections, while that of the genera Staphylococcus and Propionibacterium decreased. The risk of septic shock was negatively correlated with the quantity of bacteria from the genera Corynebacterium and Enterococcus.
Analysis of the cutaneous microbiota may, in the future, be able to identify patients at risk of complications, and the treatment of cutaneous dysbiosis may reduce the risk of infection in cases of autologous skin grafts.
Plichta JK et al. Cutaneous burn injury promotes shifts in the bacterial microbiome in autologue donor skin : implications for skin grafting outcomes. Shock. 2017 Oct.;48(4):441-448.