Epidemiology of filamentous fungal infections in burned patients: A French retrospective study

Schaal, Jean-Vivien; Leclerc, Thomas; Soler, C.; Donat, Nicolas; Cirrode, A.; Jault, P.; Bargues, L.

doi:10.1016/j.burns.2014.10.024

Cited by 47 publications

(38 citation statements)

References 35 publications

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“…Rhizomucor and Lichteimia (or Absidia). Incidence of Mucoracae was close to the incidence of Schaal et al, 16 but higher than in most previously reported series [17][18][19][20][21] in which Candida and Aspergillus were the most represented pathogens. Fusarium was rarely identified in our study (5.5% of the isolated fungi) which is in contrast to Branski et al (Fusarium was found in 30% of isolated fungi).…”

Section: Mortalitysupporting

confidence: 67%

“…In 2 cases, the reason for initial treatment modification was not found. The median duration of treatment was 18 [11][12][13][14][15][16][17][18][19][20][21] Patients with at least one filamentous infection had higher TBSA, ABSI and UBS score than patients with only yeast IFI (56% vs 39%, 12 vs 9, 192 vs 120, with P = .001, P = .002 and P = .002, respectively). Patients with filamentous infection have more burn wound coverage by skin allografts than patients with only yeast infection (46% vs 21%, P = .021).…”

Section: Treatmentmentioning

confidence: 99%

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

Maurel

Denis

Camby

et al. 2020

Mycoses

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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)

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Section: Mortalitysupporting

confidence: 67%

Section: Treatmentmentioning

confidence: 99%

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

Maurel

Denis

Camby

et al. 2020

Mycoses

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“…Early diagnosis of a burn wound infection is tricky and controversial. Incidence of mould infections in burn patients is 0.4%e1.7% [56]. Ninety-three percent of mould infections were cutaneous and among them 30% presented disseminated infection [56], mainly caused by Aspergillus, Fusarium and Mucorales (Lichtheimia sp., Mucor sp., Rhizomucor sp.…”

Section: Invasive Fungal Infections In Burn Patientsmentioning

confidence: 99%

“…and Rhizopus sp.) [56]. Infections related to filamentous fungi occurred in critical, severely burned patients with long stay in intensive care burns units and aggressive support therapy.…”

Section: Invasive Fungal Infections In Burn Patientsmentioning

confidence: 99%

New clinical phenotypes of fungal infections in special hosts

Pilmis

Puel

Lortholary

et al. 2016

Clinical Microbiology and Infection

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Incidence of invasive fungal infections increases over time with the rise in at-risk populations; in particular, patients with acquired immunodeficiencies due to immunosuppressive therapies such as anti-tumour necrosis factor-α (TNF-α) treatment, cirrhosis or burns. Some primary immunodeficiencies (PID) can also predispose selectively to invasive fungal diseases. Conversely, some atypical fungal diseases can reveal new PID. Deep dermatophytosis, Candida central nervous system infections or gastrointestinal disease, or disseminated phaeohyphomycosis-revealed CARD9 deficiency. Most patients with inherited chronic mucocutaneous candidiasis were found to carry STAT1 gain-of-function mutations. The spectrum of fungal susceptibility and clinical presentation varies according to the PID. Among acquired immunodeficiencies, immunosuppressive treatments such as TNF-α blocker therapy, which has revolutionized autoimmune disorder treatment, may be complicated by endemic mycosis, aspergillosis, pneumocystosis or cryptococcosis. Burn patients with damaged skin barrier protection are susceptible to severe Candida infections and filamentous fungal infections (such as Aspergillus spp., Mucorales). Moreover, patients with cirrhosis are at increased risk of fungal infections. Therefore, physicians should think of any potential underlying acquired or inherited immunodeficiency in a patient developing an atypical fungal infection, or of a potential fungal disease in the context of an atypical presentation in specific hosts.

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“…In a retrospective monocentric study, Schaal et al confirmed that FFIs were infrequent, essentially cutaneous, and occurred in the most severe burned patients. Moreover, Aspergillus seemed to be related with the higher mortality among FFIs 2. Schofield et al 3 reported 100% mortality for patients with invasive cutaneous aspergillosis and 38% mortality for aspergillar cutaneous colonisation.…”

Section: Discussionmentioning

confidence: 99%