Fungal colonisation in burn wounds: An Indian scenerio

Goyal, Navin Kumar; Gore, Madhuri; Goyal, R. S.

doi:10.1007/s12262-010-0009-4

Cited by 4 publications

(2 citation statements)

References 16 publications

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“…Consistent with other reports [ 29 , 52 , 53 ], the univariate analysis revealed severe infection, prolonged ICU stay, hyperglycemia, dialysis, and parenteral nutrition as the significant predictors of FC. However, based on the multivariate analysis, there were no factors predicting FC in burn patients.…”

Section: Discussionsupporting

confidence: 90%

Prevalence, species distribution, and risk factors of fungal colonization and infection in patients at a burn intensive care unit in Vietnam

Bang¹,

Xuan²,

Quang³

et al. 2020

CMM

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Background and Purpose: Burn patients are at a higher risk of infections caused by different organisms. This study aimed to address the prevalence, causative species, and factors related to fungal colonization or infection in patients with acute severe injuries admitted to the intensive care unit (ICU) of a burn hospital in northern Vietnam. Materials and Methods: This prospective study was conducted on 400 patients in a burn ICU between 2017 and 2019. Clinical samples were weekly collected and screened for fungi, and relevant clinical information was obtained from medical records. Results: According to the results, 90% of the patients were colonized with fungi. Out of this group, 12.75% of the cases had invasive fungal infection (IFI). Eleven yeasts and six mold species were isolated from the patients, with the most common species being Candida tropicalis (45.56%) and C. albicans (41.94%). Among the eleven species causing fungal wound infection (FWI), the most common agents were Candida (66.7% of FWI patients) and Aspergillus (38.5%) species. Three Candida species isolated from blood were C. tropicalis (66.7%), C. albicans (20.0%), and C. parapsilosis (14.3%). No factors were found to expose the patients to a higher risk of fungal colonization. However, hyperglycemia, prolonged ICU stay, and heavy Candida species colonization were found to be independently predictive of IFI. Conclusion: Burn patients are at the risk of fungal infection with Candida species (especially C. tropicalis) and Aspergillus as the most frequently responsible agents. Continuous surveillance of fungi and appropriate management of pathophysiological consequences are essential to prevent fungal infection in burn patients.

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Section: Discussionsupporting

confidence: 90%

Prevalence, species distribution, and risk factors of fungal colonization and infection in patients at a burn intensive care unit in Vietnam

Bang¹,

Xuan²,

Quang³

et al. 2020

CMM

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“…Infection is the leading cause of morbidity and mortality in burns and remains one of the most challenging concerns in the management of burn patients. Fungal wound colonization with the possibility of invasive infection is a probability in burn patients, in view of use of antibiotics for prolonged periods and immunosuppression associated with burn injury [2] . BWI is primarily caused by bacteria (70%) followed by fungi (20-25%), anaerobic and virus (5-10%).…”

Section: Introductionmentioning

confidence: 99%

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2019

Int. J. Dermatol. Venereology Leprosy Sci.

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Background:The burn wound represents a susceptible site for opportunistic colonization by organisms of endogenous and exogenous origin. Fungal wound infection is a leading cause of burn wound infections. Most of the fungal infections are missed owing to lack of clinical awareness and similar presentation as bacterial infection coupled with paucity of mycology laboratories. Expedient diagnosis and treatment of these mycoses can be life-saving as the mortality is otherwise very high. Objective: To study the incidence and type of fungal infection in burn patient and to evaluate its role in morbidity and mortality of burn patients. Method: This was an institution-based, prospective, non-randomized study. Skin swabs were collected from 50 patients who were admitted under department surgery with >15% burn surface area. Patients below 18 years and those with any systemic comorbidities were excluded. Results: Of total 50 patients 28 cases (56%) were positive for fungal elements, total negative cases were 22. GMS stain and 10% KOH stain (Smear test) were positive in 25 patients and culture was positive in 23 cases out of 56% of total positive cases, 33.33% were in 15-29% TBSA group, 66.7% were in 30-59% TBSA group and 78.6% were in 60% or above TBSA group. This showed a clear increase in fungal positive cases with increase of total body surface area involvement. Candida fungi were seen in the greatest fraction of patients (60.7%), Mucor-like in the smallest fraction (7%), and Aspergillus-like in an intermediate fraction (21.4%). There was higher observed mortality with deeper fungal involvement. Conclusion:This study showed that fungal infection influenced mortality and morbidity of burn patients. Also mortality due to fungal infection in these patients was significantly associated with Total body surface area (TBSA %) of burn and age of patient.

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Identification of Fungal Pathogens in Burns Patients With Reference to Candida

Jithendra¹,

Pathapati²,

Premanadham³

et al. 2014

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BACKGROUND: Infection with microbes in burns patients is a leading cause of morbidity and mortality. The present study was aimed to study the fungal pathogens from infected burns patients periodically during their stay in the hospital from wound surface, blood and intravascular devices and to identify and differentiate candida species. METHODS: This hospital based study was conducted during June 2011 to May 2013. Patients with greater than 25-30% burns of total body surface area (TBSA) and hospitalized in burns unit for a minimal duration of hospitalization of 7 days were included in the study. Specimens such as wound swabs, blood and intra vascular devices were collected at the end of 1 st ,2 nd , 3 rd and 4 th week, processing, isolation, identification and antibiogram of the isolates were done as per standard procedures. RESULTS: To analyze the systemic fungal infection in burn patient's Seven hundred and eight (708) blood cultures were collected and processed at regular intervals with isolation of 54 (7.6%) pathogens. Findings clearly indicates C.albicans as the most common pathogen 32 (59.26%) isolated followed by non-albicans group. In non-albicans group C.tropicalis was the most common followed by C.parapsoliasis and rest is C. krusei, C. kefyr, C. glabrata and C. guillermondii. Intravascular devices also act as sources for the systemic invasion of pathogens, Eight hundred and eighty four (884) IVD's were processed with isolation of 42(4.8%) pathogens. We found that C.albicans was the most common isolate 71.43% (30) followed by non-albicans group. In nonalbicans group C.tropicalis (6) was the common followed in the order of C. parapsoliasis (4), C.krusei (1) and C. guillermondii. CONCLUSION: We highlighted the incidence of fungal wound infection is increasing due to wide spectrum antibiotic administration. Candida albicans was the common pathogen isolated from all the specimens followed by C.tropicalis and C.parapsoliasis. Next common fungus isolated was Aspergillus spp which was further confirmed by histopathological correlation. Patients with fungal wound infection had long duration of hospital stay and systemic invasion had more mortality. Continuous surveillance of microorganisms and their antibiotic resistance can improve the efficacy of infection control programs in a burn unit.

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Fungal colonisation in burn wounds: An Indian scenerio

Abstract: Fungal colonisation of burn wound is not uncommon and should be suspected. Fungi detected most commonly were Candida and Aspergillus. KOH and GMS stain were identified as reliable, simple and inexpensive methods for confirming fungal colonisation.

Cited by 4 publications

References 16 publications

Prevalence, species distribution, and risk factors of fungal colonization and infection in patients at a burn intensive care unit in Vietnam

Prevalence, species distribution, and risk factors of fungal colonization and infection in patients at a burn intensive care unit in Vietnam

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Identification of Fungal Pathogens in Burns Patients With Reference to Candida

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