Fungal Infections in Burn Patients

Palackic, Alen; Popp, Daniel; Tapking, Christian; Houschyar, Khosrow Siamak; Branski, Ludwik K.

doi:10.1089/sur.2020.299

Cited by 20 publications

(15 citation statements)

References 40 publications

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“…Devrim et al conducted a study of pediatric patients with burns and found an incidence of 11.5% for IC [17]. Additionally, exposure to spores at the burn scene when the patients tried to extinguish the fire increases the possibility of IC [18]. The improvement of laboratory techniques in the identification of Candida species is also related to this increasing trend [2].…”

Section: Discussionmentioning

confidence: 99%

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Invasive Candidiasis in Hospitalized Patients with Major Burns

Lin

Chen

Yen

et al. 2022

JPM

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Background: Invasive candidiasis (IC) is a major cause of morbidities and mortality in patients hospitalized with major burns. This study investigated the incidence of IC in this specific population and analyzed the possible risk factors. Materials and Methods: We retrospectively analyzed data from the National Health Insurance Research Database (NHIRD) of Taiwan. We identified 3582 patients hospitalized with major burns on over 20% of their total body surface area (TBSA) during 2000–2013; we further analyzed possible risk factors. Result: IC was diagnosed in 452 hospitalized patients (12.6%) with major burns. In the multivariate analysis, patients older than 50 years (adjusted odds ratio (OR) = 1.96, 95% confidence interval (CI) 1.36–2.82), those of female sex (adjusted OR = 1.33, 95% CI 1.03–1.72), those with burns on the head (adjusted OR = 1.33, 95% CI 1.02–1.73), and those with burns over a greater TBSA had higher risks of IC. Conclusion: Treating IC is crucial in healthcare for major burns. Our study suggests that several risk factors are associated with IC in patients hospitalized with major burns, providing reliable reference value for clinical decisions.

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Section: Discussionmentioning

confidence: 99%

“…The distributions of Candida species can vary with the duration of prophylaxis and the antifungal agent used for prophylaxis [19]. Other treatments including aggressive surgical debridement and catheter changes are also imperative to controlling the infection [18,20].…”

Section: Discussionmentioning

confidence: 99%

Invasive Candidiasis in Hospitalized Patients with Major Burns

Lin

Chen

Yen

et al. 2022

JPM

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“…The most commonly isolated fungal species are Candida albicans and Aspergillus species. With the introduction of broad-spectrum antibiotics in the 1960s, bacterial incidence and prevalence decreased, while fungal infection incidence increased by a factor of 10 [65]. Though fungal infections are more common in burn patients with higher TBSA (>40%), recently it has been reported that infection, especially with Candida species, is not specific to TBSA, age, or inhalation injury [37].…”

Section: Fungi and Yeastsmentioning

confidence: 99%

Infection and Burn Injury

Kelly

Oliver

Carney

et al. 2022

EBJ

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Burn injury is debilitating and among one of the most frequently occurring traumas. Critical care improvements have allowed for increasingly positive outcomes. However, infection, whether it be localized to the site of the wound or systemic in nature, remains a serious cause of morbidity and mortality. Immune suppression predisposes the burn population to the development of invasive infections; and this along with the possibility of inhalation injury puts them at a significant risk for mortality. Emerging multi-drug-resistant pathogens, including Staphylococcus aureus, Enterococcus, Pseudomonas, Acinetobacter, Enterobacter, and yeast spp., continue to complicate clinical care measures, requiring innovative therapies and antimicrobial treatment. Close monitoring of antimicrobial regimens, strict decontamination procedures, early burn eschar removal, adequate wound closure, proper nutritional maintenance, and management of shock and resuscitation all play a significant role in mitigating infection. Novel antimicrobial therapies such as ultraviolet light, cold plasma and topical antiseptics must continue to evolve in order to lower the burden of infection in burn.

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“…Burn patients are cited as being among the highest risk groups for invasive fungal infections [11][12][13][14][15][16]. The burn patients loss the barrier function of the skin [17,18], the use of topical and systemic antibiotics to control bacterial infections [8,19,20], and the alteration of the immune system [21][22][23] leaves the thermally injured patient at an increased risk of infection by opportunistic organisms, including Candida. Several species of Candida have become common secondary pathogens that have become responsible for a growing number of deaths in burn patients [5,6,8,17,[24][25][26].…”

Section: Introductionmentioning

confidence: 99%

Candida albicans Infections: a novel porcine wound model to evaluate treatment efficacy

et al. 2022

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Candida albicans is a common cause of opportunistic mycoses worldwide and a major contributor in wound infections. The purpose of this study was to establish a fungal wound model and analyze the effects of a common antifungal agent against the proliferation of three C. albicans strains. Second degree burns were created, and then inoculated with one of three different C. albicans ATCC strains: 10261 reference strain, 64550 fluconazole resistant and 26310 fluconazole sensitive. After fungal inoculation, every wound was covered with dressings for 4 h to allow fungal colonization on every wound bed. After 4 h, the dressings were removed, and each wound was treated either once or twice daily with a topical terbinafine hydrochloride or left untreated. On days 2, 4 and 7 post inoculation, three wounds from each treatment group were scrub cultured and quantified. On day 2, wounds infected with the sensitive strains 26310 and 10261 and treated twice showed a significant reduction when compared against those infected wounds receiving once daily treatment. On day 4, wounds which were infected with C. albicans fluconazole sensitive (ATCC 26310) showed a significant reduction in fungal cell counts with treatment applied twice daily. A significant reduction in the colony counts was exhibited in all three strains at the seventh day with active as compared to the non-treated wounds. Twice daily treatment resulted in a lower fungal count than once daily treatment. Neither treatment was able to entirely eradicate C. albicans during the duration of this study. Establishing a reliable fungal wound model will help in the translational goal of identifying new antifungal that could be used clinically by wound care providers.

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Fungal Infections in Burn Patients

Cited by 20 publications

References 40 publications

Invasive Candidiasis in Hospitalized Patients with Major Burns

Invasive Candidiasis in Hospitalized Patients with Major Burns

Infection and Burn Injury

Candida albicans Infections: a novel porcine wound model to evaluate treatment efficacy

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