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Cited by 149Burn Injury Management and OutcomesAntifungal resistance and susceptibilityNosocomial Infections in ICU

Incidence of systemic fungal infection and related mortality following severe burns

Murray, Clinton K., Loo, Florence L., Hospenthal, Duane R., Cancio, Leopoldo C., Jones, John A., Kim, Seung H., Holcomb, John B., Wade, Charles E. +1 more·2008·Burns
DOI 10.1016/j.burns.2008.04.007
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Abstract

Advancements in burn care therapy have extended survival of seriously burned patients, exposing burn patients to increased risk of infectious complications, notably fungal infections. We performed a 12-year review of autopsied patients with severe burns for the presence of fungal infection at the US Army Institute of Surgical Research Burn Center between February 1991 and November 2003. The primary goal was to identify the relationship between fungal element noted in autopsy and mortality, and to determine contributing factors that increase a patient's susceptibility to fungal infection. A total of 228 deaths (6.1%) resulted from the 3751 admissions of which 97 underwent autopsy. Fungal elements were identified on histopathology in 44% (43 of 97) of autopsied patients with an attributable mortality of 33% (14 of 43). Aspergillus and Candida were the most frequently recovered fungi, but Aspergillus was recovered in 13 of the 14 cases with fungus identified as an attributable cause of death. The most common sites of infections with attributable mortality were wounds (86%) and the pulmonary system (14%). Total body surface area (TBSA) burn and length of stay (survival after burn) were identified as contributing factors for the incidence of fungal element in autopsy on ROC curve analysis. More severely injured patients with greater %TBSA burn injury and full-thickness burns require a longer recovery period resulting in a longer hospital stay. The propensity for fungal infection i…

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  • We identified direct evidence from three RCTs that compared procalcitonin-guided protocols for antibiotic initiation vs usual care.

    “We identified direct evidence from three RCTs that compared procalcitonin-guided protocols for antibiotic initiation vs usual care (129-131).”

    From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [130]

  • A meta-analysis of the three trials (n = 1,769 ICU patients) found no difference in short-term mortality (RR, 0.99; 95% CI, 0.86 to 1.15), length of ICU stays (MD, 0.19 days; 95% CI, -0.98 to 1.36) or length of hospitalization (MD, 7.00 days; 95% CI, -26.24 to 12.24).

    “A meta-analysis of the three trials (n = 1,769 ICU patients) found no difference in short-term mortality (RR, 0.99; 95% CI, 0.86 to 1.15), length of ICU stays (MD, 0.19 days; 95% CI, -0.98 to 1.36) or length of hospitalization (MD, 7.00 days; 95% CI, -26.24 to 12.24).”

    From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [130]

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Authors
Murray, C. K., Loo, F. L., Hospenthal, D. R., Cancio, L. C., Jones, J. A., Kim, S. H., Holcomb, J. B., Wade, C. E., & Wolf, S. E.
Affiliations
  • Brooke Army Medical Center (US)
  • United States Army Institute of Surgical Research (US)
ORCID
Venue
Burns
Publisher
Elsevier BV
Published
2008-12
Volume
34
Issue
8
Pages
1108-1112
ISSN
0305-4179 (ISSN-L)
DOI
10.1016/j.burns.2008.04.007
OpenAlex
W2031890657
Cited by
149
References
14
Citations by year
2026: 2 · 2025: 9 · 2024: 9 · 2023: 7 · 2022: 6 · 2021: 9 · 2020: 8 · 2019: 6 · 2018: 9 · 2017: 3 · 2016: 14 · 2015: 9 · 2014: 10 · 2013: 6 · 2012: 7
FWCI
8.66
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Burns (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Epidemiology › Burn Injury Management and Outcomes
  • Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
Keywords
systemic fungal infection, severe burns, burn mortality, autopsy findings, Aspergillus, Candida, wound infection, fungal lung infection, total body surface area burned, length of hospital stay, third-degree burns, antifungal therapy, burn wound closure
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Aspergillus, Autopsy, Body Surface Area, Burns, Child, Child, Preschool, Female, Humans, Length of Stay, Lung Diseases, Fungal, Male, Middle Aged, Retrospective Studies, Risk Factors, Texas, Wound Infection, Incidence, Young Adult

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