title: Epidemiological and clinico-mycological profile of fungal wound infection from largest burn centre in Asia.
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.
authors: Department of Microbiology, Vardhman Mahaveer Medical College & Safdarjung Hospital, New Delhi, India. rajeevmalini@rediffmail.com
authors: Malini R
authors: MR
authors: Capoor
authors: Sonal
authors: S
authors: Gupta
authors: Sujata
authors: S
authors: Sarabahi
authors: Anshumali
authors: A
authors: Mishra
authors: Vinay Kumar
authors: VK
authors: Tiwari
authors: Pushpa
authors: P
authors: Aggarwal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001228:Aspergillosis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D001234:Aspergillus niger / Q000187:drug effects* / Q000254:growth & development; D002053:Burn Units; D002056:Burns / Q000382:microbiology*; D002175:Candida / Q000187:drug effects* / Q000254:growth & development; D002177:Candidiasis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D025141:Drug Resistance, Fungal; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016533:Mycological Typing Techniques; D014946:Wound Infection / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D000935:Antifungal Agents