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

Autor: Maurel V; Department of Anesthesiology and Critical Care and Burn Unit, AP-HP, St-Louis Hospital, Paris, France., Denis B; Department of Infectious Diseases, AP-HP, St-Louis Hospital, Paris, France., Camby M; Department of Anesthesiology and Critical Care and Burn Unit, AP-HP, St-Louis Hospital, Paris, France., Jeanne M; Department of Anesthesiology and Intensive Care, CHU Lille, Lille, France., Cornesse A; Department of Anesthesiology and Critical Care and Burn Unit, CHU Toulouse, Toulouse, France., Glavnik B; Department of Anesthesiology and Critical Care and Burn Unit, Mercy Hospital, Metz, France., Alanio A; Molecular Mycology Unit, Institut Pasteur, CNRS, UMR2000, Paris, France.; Laboratoire de Parasitologie-Mycologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.; Sorbonne Paris Cité, Université Paris Diderot, Paris, France., Rousseau AF; Burn Intensive Center, CHU Sart-Tilman, Liège, Belgium., Lefloch R; Burn Intensive Care Unit, CHU Nantes, Nantes, France., Lagrange-Xelot M; Department of Infectious Diseases, CHU Félix Guyon, La Reunion, France., Textoris J; Department of Anesthesiology and Intensive Care, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France.; EA7426 P13 'Pathophysiology of Injury-Induced Immunosuppression', Hospices Civils de Lyon, bioMérieux, Université Claude Bernard Lyon-1, Lyon, France., Wiramus S; Department of Anesthesiology and Critical Care and Burn Unit, AP-HM, Conception Hospital, Marseille, France., de Tymowski C; Department of Anesthesiology and Critical Care and Burn Unit, AP-HP, St-Louis Hospital, Paris, France., Legrand M; Department of Anesthesiology and Critical Care and Burn Unit, AP-HP, St-Louis Hospital, Paris, France.; Sorbonne Paris Cité, Université Paris Diderot, Paris, France.; UMR INSERM 942, Institut National de la Santé et de la Recherche Médicale (INSERM), F-CRIN INI-CRCT Network, Paris, France.
Jazyk: angličtina
Zdroj: Mycoses [Mycoses] 2020 Jun; Vol. 63 (6), pp. 535-542. Date of Electronic Publication: 2020 May 10.
DOI: 10.1111/myc.13068
Abstrakt: 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) and use of skin allografts at the time of IFI diagnosis (OR = 3.87 (95% CI: 1.31-11.42), P = .021) were associated with 90-day mortality.
Conclusions: Although rare, invasive fungal infections remain associated with poor outcome in burn patients. Bacterial co-infection and presence of allograft were potentially modifiable factors independently associated with outcome.
(© 2020 Blackwell Verlag GmbH.)
Databáze: MEDLINE
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