[A clinical study of fungal infection in burn patients].
OBJECTIVE
To address the features of the fungal infection after burn injury in clinic.


METHODS
Three thousand nine hundred and nine burn patients admitted to our institute from Jan. 2003 to Dec. 2006 were involved in this study. Two thousand two hundred and seventy-one samples were harvested for fungal detection by culture from 467 patients suspected to be infected by fungi based on their clinic manifestations. The collected samples included wound tissue, blood, urine, stool, sputum, catheters and others. The antibiotic sensitivity of the identified fungi were determined by routine method. When same kind of fungus was found from different samples taken from one patient, it was recorded as one positive sample. The samples were ranked in an ascending order as wound secretion, stool, urine, sputum and bronchial alveolar lavage fluid, arteriovenous catheter or urinary catheter, blood. Only the positive sample of the highest rank source was recorded as the positive strain of fungus from this particular patient.


RESULTS
It was found 61 fungal positive samples from the 2271 samples collected. Out of 467 patients, 38 strains of fungi were detected from 36 burn patients during the investigated period, the incidence was 0.92% (36/3909). The most three commonest types among the identified 38 strains of fungi were Candida tropicalis (42.1%), Candida albicans (31.6%) and Candida famata (T. Famata, 10.5%). The drug sensitivity tests demonstrated that most of the strains detected in this investigation, with the exception of candida glabrata, were sensitive to most of the routine antimycotics agents such as Amphotericin B, Fluconazole, and Itraconazole etc. Among the 36 fungus positive patients, in 18 patients the burn area exceeded 80% TBSA, 12 patients with 50%-79% TBSA, 4 patients with 30%-49% TBSA, and in 2 patients the burn area was smaller than 30% TBSA. It was found most of the fungal infections (77.78%) occurred 2 weeks after burn injury, and 8 of the 36 fungus-infected patients died (the mortality was 22.22%). Conclusions Further examinations are necessary to confirm the diagnosis in burn patients suspected to have fungal infection. Once fungal infections are confirmed, antimycotic therapy must be started immediately.
Luo
Gao-Xing
GX
Institute of Burn Research, Southwest Hospital, State Key Laboratory of Trauma, Burns and Combined Injury, the Third Military Medical University, Chongqing 400038, China.
Peng
Yi-Zhi
YZ
Nie
Zhi-Hong
ZH
Zhang
Xiao-Bing
XB
Zhuang
Ying
Y
Yuan
Zhi-Qiang
ZQ
Zhang
Li-Hui
LH
Zhou
Mi
M
Cheng
Wen-Guang
WG
Wu
Jun
J
Zhang
Jia-Ping
JP
Luo
Qi-Zhi
QZ
Huang
Yue-Sheng
YS
D002056:Burns / Q000382:microbiology*; D002175:Candida / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D008826:Microbial Sensitivity Tests; D009181:Mycoses / Q000188:drug therapy / Q000473:pathology