DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20182934

Fungal infection profile in burn patients at a tertiary care centre of India

Imran Ahmad, Mohammed Fahud Khurram, Sudheer Kumar Maurya, Rajesh Kumar Maurya, Mohd. Tafazul Sheikh

Abstract


Background: Burn patients are at high risk of infections and burn wound infection is one of the most important factor responsible for their morbidity and mortality. Burn patients have increased incidence of fungal infection in comparison to others. Fungal infection is difficult to diagnose because it has similar symptoms like bacterial infections. Common fungal organism causing burn wounds infections are Candida sp., Aspergillus sp., non albicans Candida, Zygomycetes etc.

Methods: This prospective study was carried out in Department of Burn, Plastic and Reconstructive Surgery, J.N.M.C.H., Aligarh Muslim University, India from December 2015 to June 2017. Patients having 20 to 60% body surface area involvement with more than 5 years of age with no comorbidity were included in this study.

Results: In our study, total 126 patients were included, 9 male patients (18.37%) were found fungal culture positive whereas 14 females (18.18%) were culture positive. 12 patients (9.52%) were found to be positive for Candida albicans, 6 patients (4.76%) were Aspergillus flavus positive, 3 patients (2.38%) were positive for Non Candida albicans and 2 patients (1.59%) were positive for Aspergillus niger.

Conclusions: Fungal burn wound infections are one of the most common cause of late onset morbidity and mortality in burn patients. So, high level of suspicion and tissue culture are essential in making early diagnosis and treatment. Judicious use of antibiotics are also necessary for decreasing its incidence.


Keywords


Antibiotic, Burn, Fungal profile

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References


Mousa HA, Al-Bader SM, Hassan DA. Correlation between fungi isolated from burn wounds and burn care units. Burns. 1999 Mar 1;25(2):145-7.

Ballard J, Edelman L, Saffle J, Sheridan R, Kagan R, Bracco D, et al. Positive fungal cultures in burn patients: a multicenter review. J burn care & research. 2008 Jan 1;29(1):213-21.

Branski LK, Al-Mousawi A, Rivero H, Jeschke MG, Sanford AP, Herndon DN. Emerging infections in burns. Surgical infections. 2009 Oct 1;10(5):389-97.

Kratzer C, Graninger W, Lassnigg A, Presterl E. Design and use of Candida scores at the intensive care unit. Mycoses. 2011 Nov 1;54(6):467-74.

Mousa HA. Fungal infection of burn wounds in patients with open and occlusive treatment methods. East Mediterr Health J. 1999;5:333-6.

Mousa HA, al-Bader SM. Yeast infection of burns. Mycoses. 2001;44:147-9.

Wisplinghoff H, Bischoff T, Tallent SM, Seifert H, Wenzel RP, Edmond MB. Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis. 2004;39:309-17.

Horvath EE, Murray CK, Vaghan GM, Chung KK, Hospenthal DR, Wade CE, et al. Fungal wound infection (not colonization) is independently associated with mortality in burn patients. Ann Surg. 2007;245:978-85.

Chakrabarti A, Chatterjee SS, Rao KL, Zameer MM, Shivaprakash MR, Singhi S, et al. Recent experience with fungemia: Change in species distribution and azole resistance. Scand J Infect Dis. 2009;41:275-84.

Bruck HM, Nash G, Foley FD, Pruitt BA. Opportunistic Fungal infection of burn wound with phycomycetes and aspergillus. A Clinical-pathological review. Arch Surg. 1971;102:476.

Ibrahim NH, Amer TA. Frequency of bacterial and fungal infections of burn wounds at cairo university burn centre. Egy J Med Microbiol. 2008;17:573-82.

Pfaller MA, Diekema DJ, Messer SA, Boyken L, Hollis RJ. Activities of fluconazole and voriconazole against 1,586 recent clinical isolates of Candida species determined by broth microdilution, disk diffusion and E-test method: Report form the ARTEMIS Global Antifungal Susceptibility Program, 2001. J Clin Microbiol. 2003;41:1440-6.

Walsh T, Dixon D. Nosocomial aspergillosis: environmental microbiology, hospital epidemiology, diagnosis and treatment. Eur J Epi. 1989;5:131-42.

Fridkin SK, WR Jarvis. Epidemiology of nosocomial fungal infections. Clin Microbiol Rev. 1996;9:499-5110.