Epidemiological and clinico-mycological profile of fungal wound infection from largest burn centre in Asia

Mycoses. 2012 Mar;55(2):181-8. doi: 10.1111/j.1439-0507.2011.02065.x. Epub 2011 Jul 10.

Abstract

The current study was conducted to know the incidence, predisposing factors, spectrum, clinical profile and antifungal susceptibility (AFS) of fungal wound infection (FWI) in burn patients. Of a total of 71 patients, 20 (28.2%) emerged with the diagnosis of FWI. Fungal pathogens in this study were Candida tropicalis (14%), Candida parapsilosis (5.6%), Aspergillus niger (2.8%) and one each of Candida albicans (1.4%), Candida glabrata (1.4%), Syncephalestrum (1.4%) and Fusarium solani (1.4%). All patients with mould infections expired before the mycological culture results could be conveyed to clinicians. Of the yeasts isolated in the study, one each of C. tropicalis and C. albicans showed cross-resistance to azoles. All the moulds were susceptible to amphotericin B. This study depicted that fungal invasion is associated with a high mortality, burn size 30-60% and high incidence of inhalational injury. Fungal invasion was detected on an average of 14 days after injury. Association of use of four classes of drugs - aminoglycosides, imipenem, vancomycin and third generation cephalosporins and use of total parenteral nutrition was observed. Expedient laboratory diagnosis of FWI and appropriate systemic antifungal therapy guided by AFS may improve outcome for severely injured burn victims.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use
  • Antifungal Agents / administration & dosage
  • Antifungal Agents / therapeutic use
  • Aspergillosis / drug therapy
  • Aspergillosis / epidemiology*
  • Aspergillosis / microbiology
  • Aspergillus niger / drug effects*
  • Aspergillus niger / growth & development
  • Burn Units
  • Burns / microbiology*
  • Candida / drug effects*
  • Candida / growth & development
  • Candidiasis / drug therapy
  • Candidiasis / epidemiology*
  • Candidiasis / microbiology
  • Child
  • Child, Preschool
  • Drug Resistance, Fungal
  • Female
  • Humans
  • India / epidemiology
  • Male
  • Middle Aged
  • Mycological Typing Techniques
  • Wound Infection / microbiology*

Substances

  • Anti-Bacterial Agents
  • Antifungal Agents