Robert Maile, Ph.D., has long been interested in the early diagnosis of sepsis in patients with severe burns, which cause immune system suppression, allowing infection to take hold more easily and to grow more quickly in severity.
One of the challenges, Maile said, is that many of the hallmarks of severe burn injuries, such as high body temperatures and shock responses, are also indicative of sepsis. This means it can be hard to tell where one ends and the other begins.
“One of the holy grails in sepsis research is to determine how to detect the very early stages of sepsis,” said Maile, an associate professor in the University of Florida Department of Surgery and co-director of the Sepsis and Critical Illness Research Center at UF.
Maile’s lab is looking for that holy grail, using data from a centralized burn biorepository maintained at UF and comprising thousands of burn patient data points.
By collecting and analyzing that data, Maile hopes to identify individual biomarkers that can predict whether a patient is more likely to succumb to sepsis, augmenting previously established static risk factors like burn area, patient age and type of injury.
Early identification would mean clinicians, such as those at the UF Health Shands Burn Center, would have even more tools at their disposal to improve outcomes.
Philip Efron, M.D., a professor in the Department of Surgery and co-director of the Sepsis and Critical Illness Research Center, emphasizes that research on the intersection of burns and sepsis is both important and ongoing.
“There’s a lot of knowledge and data we don’t have yet, but at the University of Florida we’re trying to do paradigm-changing research in critical care,” Efron said.
Predictive analysis is only a small piece of the ongoing fight to improve care for burn patients.
“It all comes down to the art of the burn surgeon,” said Maile. “Knowing their patients, knowing what their course of treatment should be like and quickly picking up when something is wrong with a patient… that skill and care still outperforms any kind of test or drug we currently have.”
Andrea Munden, M.D., an assistant professor in the Department of Surgery, is one such burn surgeon. As the interim director of the UF Health Shands Burn Center, she oversees one of the busiest burn centers in the United States, with over 600 burn patients admitted to UF Health Shands Hospital annually and many more treated in the clinic via outpatient appointments.
Munden underscores why better early signals matter at the bedside, noting that recognizing sepsis isn’t easy.
“There’s a tension when it comes to severe burn patients,” she said. “They need frequent surgeries to address and clean these major wounds, but taking sick patients to the operating room also introduces new risk factors. These can be difficult decisions.”
Work like Maile’s, which aims to create clearer signals and predictors of infection, would sharpen that decision-making process, support antimicrobial stewardship and standardize escalation across long-term admissions.