Identification and Validation of Biomarkers for Infections in Burns

The burn literature is replete with suggested biomarkers of infections for identifying
sepsis or other infections in burn patients, however, these reports are largely untested. In
order for incorporation of infection biomarker assessment to become the standard of care,
validation of these markers in a multi-center prospective study is necessary. As the
majority of these biomarkers have been chosen because of success in other patient
populations, or ease of measurement, it is possible that the best biomarkers of infection
have not yet been discovered in this patient population. Prospective identification and
validation of novel biomarkers may also improve early identification of infections in burn
patients. Early treatment of infections and sepsis directly correlated with improved
survival and reduced costs of care.

In this prospective, multi-center study, 200 patients from four participating Texas burn
hospitals will be enrolled from admission to discharge. The clinical research study team
will collect approximately 11 serum samples and clinical data related to sepsis and
infection predictors from severely burned adult patients, ages 18-80 years old. All serum
samples from participating sites will be shipped to the lead site, University of Texas
Medical Branch. The University of Texas Medical Branch will then validate previously
identified biomarkers while simultaneously identifying novel biomarkers through discovery
proteomics.

Inclusion Criteria:

- Ages 18-80 years old

- Greater than 20% Total Body Surface Area burn

- Patient arrival to the burn center within 7 days of burn injury

Exclusion Criteria:

- Known history of acquired immunodeficiency syndrome (AIDS), AIDS-related complex
(ARC), human immunodeficiency virus (HIV)

- History of cancer within 5 years

- Pregnancy

- Burn injury due to chemical burns or deep electrical injury

- Inability to obtain informed consent

- Decision not to treat due to burn injury severity or futility as deemed by the
clinical team at the time of admission (Note: This is a clinical determination of
futility beyond which survival is rare. These are typically patients whose sum of
Total Body Surface Area % burn and age (Baux score) exceeds 140 or 120 with severe
inhalation injury.)

- Presence of anoxic brain injury that is not expected to result in complete recovery