Outcome and characteristics of invasive fungal infections in critically ill burn patients: A multicenter retrospective study

被引:17
|
作者
Maurel, Veronique [1 ,2 ]
Denis, Blandine [3 ]
Camby, Matthieu [1 ,2 ]
Jeanne, Mathieu [4 ]
Cornesse, Aline [5 ,6 ]
Glavnik, Boris [7 ,8 ]
Alanio, Alexandre [9 ,10 ,11 ]
Rousseau, Anne-Francoise [12 ]
Lefloch, Ronan [13 ]
Lagrange-Xelot, Marie [14 ]
Textoris, Julien [15 ,16 ]
Wiramus, Sandrine [17 ]
de Tymowski, Christian [1 ,2 ]
Legrand, Matthieu [1 ,2 ,11 ,18 ]
机构
[1] St Louis Hosp, AP HP, Dept Anesthesiol & Crit Care, Paris, France
[2] St Louis Hosp, AP HP, Burn Unit, Paris, France
[3] St Louis Hosp, AP HP, Dept Infect Dis, Paris, France
[4] CHU Lille, Dept Anesthesiol & Intens Care, Lille, France
[5] CHU Toulouse, Dept Anesthesiol & Crit Care, Toulouse, France
[6] CHU Toulouse, Burn Unit, Toulouse, France
[7] Mercy Hosp, Dept Anesthesiol & Crit Care, Metz, France
[8] Mercy Hosp, Burn Unit, Metz, France
[9] Inst Pasteur, Mol Mycol Unit, UMR2000, CNRS, Paris, France
[10] Hop St Louis, Grp Hosp St Louis Lariboisiere Fernand Widal, AP HP, Lab Parasitol Mycol, Paris, France
[11] Univ Paris Diderot, Sorbonne Paris Cite, Paris, France
[12] CHU Sart Tilman, Burn Intens Ctr, Liege, Belgium
[13] CHU Nantes, Burn Intens Care Unit, Nantes, France
[14] CHU Felix Guyon, Dept Infect Dis, La Reunion, France
[15] Hosp Civils Lyon, Edouard Herriot Hosp, Dept Anesthesiol & Intens Care, Lyon, France
[16] Univ Claude Bernard Lyon 1, Hosp Civils Lyon, BioMerieux, EA7426 P13 Pathophysiol Injury Induced Immunosu, Lyon, France
[17] Concept Hosp, AP HM, Dept Anesthesiol & Crit Care & Burn Unit, Marseille, France
[18] Inst Natl Sante & Rech Med INSERM, F CRIN INI CRCT Network, UMR INSERM 942, Paris, France
关键词
burn patients; filamentous infection; invasive fungal infection; mortality; yeast infection; WOUND-INFECTION; EARLY-DIAGNOSIS; MUCORMYCOSIS; MORTALITY; COLONIZATION; EPIDEMIOLOGY; CANDIDEMIA; MANAGEMENT; INJURY; DNA;
D O I
10.1111/myc.13068
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
Background Characteristics and outcome of invasive fungal infection (IFI) in critically ill burn patients have been poorly explored. Objectives We report the factors associated with 90-day mortality in a multicentre retrospective European study. Patients/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 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 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.
引用
收藏
页码:535 / 542
页数:8
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