Outcome and characteristics of invasive fungal infections in critically ill burn patients: A multicenter retrospective study.
burn patients
filamentous infection
invasive fungal infection
mortality
yeast infection
Journal
Mycoses
ISSN: 1439-0507
Titre abrégé: Mycoses
Pays: Germany
ID NLM: 8805008
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
received:
23
12
2019
revised:
16
02
2020
accepted:
18
02
2020
pubmed:
23
2
2020
medline:
30
1
2021
entrez:
21
2
2020
Statut:
ppublish
Résumé
Characteristics and outcome of invasive fungal infection (IFI) in critically ill burn patients have been poorly explored. We report the factors associated with 90-day mortality in a multicentre retrospective European study. All burn patients with confirmed IFI admitted between 1 January 2010 to 31 December 2015 in 10 centres in France and Belgium were included. Ninety-four patients were enrolled with 110 cases of IFIs: 79 (71.8%) were yeasts IFI and 31 (28.2%) filamentous IFI. Incidence was 1% among admitted patients. The 90-day mortality was 37.2% for all IFIs combined, 52% for filamentous infection and 31.9% for yeast infection. Patients with more than one IFI had a higher 90-day mortality than patients with only one episode (61.5% vs 33.5% (P = .006)). In multivariate analysis, higher Simplified Acute Physiology Score II (OR = 1.05 (95% CI: 1.02-1.09) P = .003), bacterial co-infection (OR = 3.85 (95% CI: 1.23-12.01), P = .014) and use of skin allografts at the time of IFI diagnosis (OR = 3.87 (95% CI: 1.31-11.42), P = .021) were associated with 90-day mortality. Although rare, invasive fungal infections remain associated with poor outcome in burn patients. Bacterial co-infection and presence of allograft were potentially modifiable factors independently associated with outcome.
Sections du résumé
BACKGROUND
BACKGROUND
Characteristics and outcome of invasive fungal infection (IFI) in critically ill burn patients have been poorly explored.
OBJECTIVES
OBJECTIVE
We report the factors associated with 90-day mortality in a multicentre retrospective European study.
PATIENTS/METHODS
METHODS
All burn patients with confirmed IFI admitted between 1 January 2010 to 31 December 2015 in 10 centres in France and Belgium were included.
RESULTS
RESULTS
Ninety-four patients were enrolled with 110 cases of IFIs: 79 (71.8%) were yeasts IFI and 31 (28.2%) filamentous IFI. Incidence was 1% among admitted patients. The 90-day mortality was 37.2% for all IFIs combined, 52% for filamentous infection and 31.9% for yeast infection. Patients with more than one IFI had a higher 90-day mortality than patients with only one episode (61.5% vs 33.5% (P = .006)). In multivariate analysis, higher Simplified Acute Physiology Score II (OR = 1.05 (95% CI: 1.02-1.09) P = .003), bacterial co-infection (OR = 3.85 (95% CI: 1.23-12.01), P = .014) and use of skin allografts at the time of IFI diagnosis (OR = 3.87 (95% CI: 1.31-11.42), P = .021) were associated with 90-day mortality.
CONCLUSIONS
CONCLUSIONS
Although rare, invasive fungal infections remain associated with poor outcome in burn patients. Bacterial co-infection and presence of allograft were potentially modifiable factors independently associated with outcome.
Substances chimiques
Antifungal Agents
0
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
535-542Subventions
Organisme : The Research group SPILF-CMIT (Société De Pathologie Infectieuse de Langue Française-Collègue des Universitaires de maladie infectieuses et Tropicales)
Informations de copyright
© 2020 Blackwell Verlag GmbH.
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