cutaneous aspergillosis risk factors in a burns treatment center.

J. Schaal, T. Leclerc, P. Jault, C. Soler, L. Bargues

Abstract: 

Study Purpose: Fungal infections are becoming more common in burn patients [1]. This retrospective study reviews all burn patients admitted to our center between 2000 and 2011, with a positive skin levy Aspergillus sp.The aim of this work is to identify aspergillosis risk factors in a burns treatment center (BTC).

Methods: The aspergillosis (ASP) were separated into three categories [2]:

  1. cutaneous fungal colonization (CFCs)
  2. fungal skin infection (IFC) defined by a positive mycological sampling associated with SIRS, sepsis or severe local skin infection signs
  3. disseminated infection (ID) defined by IFC associated with a positive blood culture positive antigenemia or a secondary location. We identified risk factors usual aspergillosis. [3] The average total burned skin surfaces (SCBT) and deep (SCBP) score LEASES and ABSI were compared according to the type of injury aspergillosis (Kruskal-Wallis test).

Results: Of 1575 hospitalized patients (mean SBCT 23 ± 22%), 20 patients had a PSA (SCBT 65%, p = 0.02, Wilcoxon test): 5 CFC, 8 and 7 IFC ID. 1 patient receiving corticosteroid therapy (IFC) and 1 chronic respiratory failure patients (CFCs) are raised. There are no diabetic patient, transplant, immunosuppressive, neutropenic treatment (<1000 / mm3) during hospitalization, cirrhotic, suffering from hematological malignancies, cancer or HIV infection. The average of the four variables (SCBT, SCBP, LEASES, ABSI) appear to be higher in case of IFI or ID in case of CFC (figure 1); However, the differences were not significant (Table 1)

Conclusion: The burning and severity appear to be major aspergillosis risk factors in our patients. Studies with larger numbers are needed to identify risk factors specific to burned.

 

Table 1

variables

(Mean ± SD)

CFC

 

IFC

ID

P

Kruskal-Wallis

SCBT

51 ± 29

70 ± 22

68 ± 18

0.36

SCBP

43 ± 30

49 ± 24

62 ± 23

0.37

LEASES

92 ± 18

110 ± 26

120 ± 32

0.07

ABSI

9 ± 2

11 ± 3

12 ± 2

0.23

 

2012

Full conference title: 

Réunion Interdisciplinaire de Chimiothérapie Anti Infectieuse
    • RICAI 32nd (2012)