title: Incidence of non-candidal fungal infections in severe burn injury: an Australian perspective.
abstract: BACKGROUND
  Infection remains the primary cause of morbidity and mortality in the burns patient population. While candidal infection in burns patients is well described, there is dearth of information regarding non-candidal fungal infections in this setting.
  
  
  METHODS
  All adult burns patients who developed non-candidal fungal infections over a period of 10 years (between January 2001 and June 2011) were included. Retrospective data analyzed included patient demographics, organisms cultured, antibiotic susceptibility patterns, treatment, length of stay and overall mortality.
  
  
  RESULTS
  The incidence of non-candidal fungal infections at our centre over the time period studied was 0.04%. A total of 12 patients had a fungus other than Candida isolated. Of these 12 patients, seven were thought to have clinically significant fungal infections and were treated with targeted anti-fungal therapy. Between them, seven species of fungus were isolated: Aspergillus fumigatus (n=7), Scedosporium prolificans (n=2), Fusarium solani (n=2), Mucor spp. (n=2), Absydia corymbifera (n=1), Penicillium (n=1) and Alternaria spp. (n=1). Of those definitively treated, two died, although fungal infection was not believed to be a contributing factor to these deaths.
  
  
  CONCLUSIONS
  We demonstrate a low incidence and attributable mortality of non-candidal fungal infections in the setting of early antifungal therapy and extensive surgical debridement at our state-wide Burns Service.
authors.affiliation: Victorian Adult Burns Service, The Alfred Hospital, Commercial Road, Melbourne, Victoria, Australia. Electronic address: tkat4147@uni.sydney.edu.au.
authors.forename: T
authors.initials: T
authors.lastname: Katz
authors.affiliation: Victorian Adult Burns Service and School of Public Health and Preventive Medicine, Monash University, The Alfred Hospital, Commercial Road, Melbourne, Victoria, Australia. Electronic address: J.Wasiak@alfred.org.au.
authors.forename: J
authors.initials: J
authors.lastname: Wasiak
authors.affiliation: Victorian Adult Burns Service and Department of Surgery, Monash University, The Alfred Hospital, Commercial Road, Melbourne, Victoria, Australia.
authors.forename: H
authors.initials: H
authors.lastname: Cleland
authors.affiliation: Department of Infectious Diseases, The Alfred Hospital, Commercial Road, Melbourne, Victoria, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Padiglione
mesh_terms: D000328:Adult; D000368:Aged; D000528:Alternaria / Q000302:isolation & purification; D060487:Alternariosis / Q000150:complications* / Q000188:drug therapy; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000150:complications* / Q000188:drug therapy; D001232:Aspergillus fumigatus / Q000302:isolation & purification; D001315:Australia; D002056:Burns / Q000150:complications*; D015331:Cohort Studies; D005260:Female; D060585:Fusariosis / Q000150:complications* / Q000188:drug therapy; D005670:Fusarium / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D009089:Mucor / Q000302:isolation & purification; D009091:Mucormycosis / Q000150:complications* / Q000188:drug therapy; D009181:Mycoses / Q000150:complications / Q000188:drug therapy / Q000382:microbiology; D010407:Penicillium / Q000302:isolation & purification; D012189:Retrospective Studies; D021681:Scedosporium / Q000302:isolation & purification; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000935:Antifungal Agents