Multi-state evaluation of Candida infections in burn patients.

Autor: Salimi M; Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.; Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran., Javidnia J; Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.; Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran., Abastabar M; Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.; Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran., Mobayen MR; Burn and Regenerative Medicine Research Center, Guilan University of Medical Science, Rasht, Iran., Moslemi A; Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.; Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran., Rahimzadeh G; Pediatric Infectious Diseases Research Center, Communicable Diseases Institute Mazandaran University of Medical Sciences, Sari, Iran., Yazdani Charati J; Department of Biostatics, Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran., Mirzaei Tirabadi N; Department of Infectious Disease and Tropical Medicine, Shahid Motahari Burns Hospital, Iran University of Medical Sciences, Tehran, Iran., Nouranibaladezaei S; Burn Center, Zare Hospital, Mazandaran University of Medical Sciences, Sari, IR, Iran., Asghari H; Burn Center, Zare Hospital, Mazandaran University of Medical Sciences, Sari, IR, Iran., Sobouti B; Infectious Disease Research Center, Ali-Asghar Children Hospital, Iran University of Medical Sciences, Tehran, Iran., Dahmardehei M; Department of Plastic and Reconstructive Surgery, Burn Research Center, Iran University of Medical Sciences, Tehran, Iran., Seyedmousavi S; Department of Laboratory Medicine, Microbiology Service, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA., Shokohi T; Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.; Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
Jazyk: angličtina
Zdroj: Mycoses [Mycoses] 2024 Aug; Vol. 67 (8), pp. e13788.
DOI: 10.1111/myc.13788
Abstrakt: Background: Burn patients are at high risk of developing secondary invasive fungal infections due to their compromised skin barrier, extensive use of antibiotics, and immunosuppression.
Objectives: We investigated demographic characteristics and clinical factors associated with Candida infections in intensive care unit (ICU) burn patients, and the in vitro antifungal susceptibility of species of isolates.
Methods: A total of 353 burn patients admitted to three major ICUs of burn centers in Iran were evaluated between 2021 and 2023. Patients were considered as colonisation and candidemia. Demographic characteristics, burn-related factors, and clinical conditions were compared among the groups. Furthermore, we identified fungi at the species level and performed antifungal susceptibility testing according to CLSI guidelines.
Results: Overall, 46.2% of patients were colonised with a Candida species, leading to candidemia in 15.3%. The most frequently isolated species from candidemia and burn wound colonisation were Candida parapsilosis (37.0%) and Candida albicans (31.9%), respectively. Risk factors linked to candidemia included larger total body surface area (TBSA) (>50%), older patients, indwelling catheters, diabetes, and an extended ICU stay. Mortality rate was higher among candidemia patients (82.5%) compared to colonised patients (7.3%). The resistance rate of the strains isolated from candidemia to fluconazole and voriconazole was 28% and 18.2%, respectively.
Conclusion: We found that a higher percentage of TBSA burn injuries, longer hospital stays, and catheterization are important predictors of candidemia. The mortality rate was significantly higher in people infected with non-albicans Candida species. Prevention and treatment strategies for candidemia should be based on updated, regional epidemiological data.
(© 2024 Wiley‐VCH GmbH. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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