Burn damage can lead to a state of immune dysregulation that facilitates the development of infections in patients. The most deleterious impact of this dysfunction is the loss of the skin’s natural protective barrier. Furthermore, the risk of infection is exacerbated by protracted hospitalization, urinary catheters, endotracheal intubation, inhalation injury, arterial lines and central venous access, among other mainstays of burn care. Currently, infections comprise the leading cause of mortality after major burn injuries, which highlights the improvements observed over the last 50 years in the care provided to burn victims. The need to implement the empirical selection of antibiotic therapy to treat multidrug-resistant bacteria may concomitantly lead to an overall pervasiveness of difficult-to-treat pathogens in burn centres, as well as the propagation of antimicrobial resistance and the ultimate dysregulation of a healthy microbiome. While preliminary studies are examining the variability and evolution of human and mice microbiota, both during the early and late phase burn injury, one must consider that abnormal microbiome conditions could influence the systemic inflammatory response. A better understanding of the changes in the post-burn microbiome might be useful to interpret the provenance and subsequent development of infections, as well as to come up with inferences on the prognosis of burn patients. This review aims to summarise the current findings describing the microbiological changes in different organs and systems of burn patients and how these alterations affect the risks of infections, complications, and, ultimately, healing.

中文翻译：

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烧伤患者中的微生物组：对感染和临床结果的影响。

烧伤损害可导致免疫失调状态，从而促进患者感染的发展。这种功能障碍最有害的影响是失去皮肤天然的保护屏障。此外，长期的住院治疗，导尿管，气管内插管，吸入性损伤，动脉管路和中心静脉通路以及其他烧伤护理的主要手段，进一步加剧了感染的风险。目前，感染是严重烧伤造成死亡的主要原因，这突出表明了在过去50年中在烧伤受害者护理方面的改善。需要实施经验性的抗生素疗法来治疗耐多药细菌的选择，可能会导致烧伤中心难以治疗的病原体全面泛滥，以及抗菌素耐药性的传播和健康微生物组的最终失调。初步研究正在研究人和小鼠微生物群在早期和晚期烧伤过程中的变异性和进化，但必须考虑到异常的微生物组状况可能会影响全身性炎症反应。更好地了解烧伤后微生物组的变化可能有助于解释感染的来源和随后的发展，并有助于推断烧伤患者的预后。这篇综述旨在总结当前的发现，这些发现描述了烧伤患者不同器官和系统中的微生物变化，以及这些变化如何影响感染，并发症和最终治愈的风险。