title: Epidemiology of filamentous fungal infections in burned patients: A French retrospective study.
abstract: BACKGROUND
  Filamentous fungal infections (FFI) seem to become more frequent in burn patients, in whom they are usually accepted to cause severe. However published data regarding their incidence and consequences in that context remain scarce. The aim of this study was to evaluate the incidence of mould infections in our burn centre, and to review characteristics and outcomes of patients with such infections.
  
  
  METHODS
  This retrospective single-centre study reviews all patients admitted in our centre with acute burns (2000-2011) and positive culture for moulds. Wound infections were defined as follows: fungal wound colonisations (FWC) for positive mycological cultures without signs of wound infection; fungal wound infections (FWI) for positive mycological cultures with local signs of wound infection; disseminated infection (DI) for FWI with a positive blood culture or a positive galactomannan (for aspergillosis) or severe sepsis or secondary organ localisation(s).
  
  
  RESULTS
  Among 1849 patients, 31 patients presented a FFI. For 29 patients (93%), positive fungal samples were cutaneous: 20 Aspergillosis ASP (5 FWC, 8 FWI and 7 DI), 9 mucormycosis MMC (3 FWC and 6 FWI) and 3 fusariosis FUS (3 FWI). Two patients presented a catheter colonisation or a pulmonary colonisation (Aspergillus fumigatus). Incidence of FFI was 1.7%. Total body surface area burned, full-thickness burn surface area, Unit Burn Standard, Tobiasen score and SAPS2 (respectively 55% [40-73], 45% [30-63], 180 [129-259], 11 [8-12] and 50 [40-62]) were markedly higher than in burned patients without FFI hospitalised during the same time period. 30% of the patients with burn wound ASP (6/22) died. Mean length of stay was 111±67 days.
  
  
  CONCLUSIONS
  FFI are essentially cutaneous, infrequent and occur in the most severe burned patients. ASP seems to be more serious than other FFI.
authors: Burn Centre, Military Teaching Hospital Percy, 101 Avenue Henri Barbusse, 92140 Clamart, France. Electronic address: jeanvivien.schaal@yahoo.fr.
authors: J V
authors: JV
authors: Schaal
authors: Burn Centre, Military Teaching Hospital Percy, 101 Avenue Henri Barbusse, 92140 Clamart, France.
authors: T
authors: T
authors: Leclerc
authors: Department of Mycology, Military Teaching Hospital Percy, 101 Avenue Henri Barbusse, 92140 Clamart, France.
authors: C
authors: C
authors: Soler
authors: Burn Centre, Military Teaching Hospital Percy, 101 Avenue Henri Barbusse, 92140 Clamart, France.
authors: N
authors: N
authors: Donat
authors: Burn Centre, Military Teaching Hospital Percy, 101 Avenue Henri Barbusse, 92140 Clamart, France.
authors: A
authors: A
authors: Cirrode
authors: Burn Centre, Military Teaching Hospital Percy, 101 Avenue Henri Barbusse, 92140 Clamart, France.
authors: P
authors: P
authors: Jault
authors: Burn Centre, Military Teaching Hospital Percy, 101 Avenue Henri Barbusse, 92140 Clamart, France.
authors: L
authors: L
authors: Bargues
mesh_terms: D000293:Adolescent; D000328:Adult; D001228:Aspergillosis / Q000453:epidemiology* / Q000382:microbiology; D002056:Burns / Q000453:epidemiology* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005602:France / Q000453:epidemiology; D060585:Fusariosis / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009091:Mucormycosis / Q000453:epidemiology* / Q000382:microbiology; D009181:Mycoses / Q000453:epidemiology / Q000382:microbiology; D012189:Retrospective Studies; D015208:Smoke Inhalation Injury / Q000453:epidemiology; D014946:Wound Infection / Q000453:epidemiology* / Q000382:microbiology; D055815:Young Adult
keywords: Burn; Filamentous fungi; Fungal infection