title: [Invasive yeast infections in severely burned patients].
abstract: Currently, there are few studies on candidaemia in the severely burned patient. These patients share the same risk factors for invasive fungal infections as other critically ill patients, but have certain characteristics that make them particularly susceptible. These include the loss of skin barrier due to extensive burns, fungal colonisation of the latter, and the use of hydrotherapy or other topical therapies (occasionally with antimicrobials). In addition, the increased survival rate achieved in recent decades in critically burned patients due to the advances in treatment has led to the increase of invasive Candida infections. This explains the growing interest in making an earlier and more accurate diagnosis, as well as more effective treatments to reduce morbidity and mortality of candidaemia in severe burned patients. A review is presented on all aspects of the burned patient, including the predisposition and risk factors for invasive candidiasis, pathogenesis of candidaemia, underlying immunodeficiency, local epidemiology and antifungal susceptibility, evolution and prognostic factors, as well as other non-Candida yeast infections. Finally, we include specific data on our local experience in the management of candidaemia in severe burned patients, which may serve to quantify the problem, place it in context, and offer a realistic perspective.
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario y Politécnico La Fe, Valencia, España.
authors.forename: Ana Isabel
authors.initials: AI
authors.lastname: Renau
authors.affiliation: Servicio de Enfermedades Infecciosas, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, España.
authors.forename: Carolina
authors.initials: C
authors.lastname: García-Vidal
authors.affiliation: Unidad de Enfermedades Infecciosas, Hospital Universitario y Politécnico La Fe, Valencia, España. Electronic address: salavert_mig@gva.es.
authors.forename: Miguel
authors.initials: M
authors.lastname: Salavert
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D002056:Burns / Q000150:complications*; D058387:Candidemia / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D058365:Candidiasis, Invasive / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D025141:Drug Resistance, Fungal; D006801:Humans; D015601:Injury Severity Score; D011379:Prognosis; D012307:Risk Factors
chemical_list: D000935:Antifungal Agents
keywords: Burned patients; Candidaemia; Candidemia; Candidiasis; Catéter vascular; Lesión térmica grave; Mortalidad; Mortality; Pacientes quemados; Severe thermal injury; Vascular catheter