Epidemiology of filamentous fungi in a burns treatment center.

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

Abstract: 

Study Purpose:  Fungal infections are becoming more common in burn patients [1]. The aim of this study is to collect epidemiological data on filamentous fungi infections in burns treatment center (BTC).

Methods:  This retrospective study reviews all burn patients admitted to our center between 2000 and 2011, with a positive levy filamentous fungus. For cutaneous, the patients were divided into three categories: [2]

  1. cutaneous fungal colonization (CFCs)
  2. fungal skin infection (IFC) defined by a positive mycological sampling associated with SIRS, severe sepsis or local signs of skin infections (including superficial and deep skin infections)
  3. disseminated infection (ID) defined by IFC associated with a positive blood culture positive antigenemia or a secondary location. We noted the mycological, demographic and mortality.

Results:  Of 1575 hospitalized patients (total burned area (SBT) averaged 23 ± 22%), 29 patients had cutaneous fungal reached 20 aspergillosis (ASP 5 CFC 8 IFC and 7 ID), 9 mucormycosis MMC (3 CFC and 6 IFC), 3 fusarioses FUS (3 IFIs). Two Aspergillus colonization (respiratory and catheter) were identified. Figure 1 shows the identification of the fungal species. 23 patients were burned in France and 8 were burned oversea. For ASP, MMC and FUS, the implications are respectively 1.2, 0.5 and 0.2%; the time of occurrence are respectively 7 ± 5, ± 4 and 5 ± 2 two weeks; SBT and medium deep burn area are 58% ± 23 and 47 ± 24%; scores UBS UBSC and IGS2 are 196 ± 92, respectively, 248 ± 113 and 50 ± 18. The average hospital stay is 111 ± 67 days. 6 patients died, all with ASP / ID, representing 27% of ASP. 2 patients had a co-infection ASP / MMC and died.

Conclusion:  The filamentous fungi infections occur in severely burned patients. Aspergillosis seems burdened with significant mortality when it is disseminated.

2012

Full conference title: 

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