Outcome and Characteristics of Invasive Fungal Infections in critically ill burn patients: A multicenter retrospective study

Outcome and Characteristics of Invasive Fungal Infections in critically ill burn patients: A multicenter retrospective study:

Abstract

Background

Characteristics and outcome of Invasive fungal infection (IFI) in critically ill burn patients have been poorly explored.

Objectives

We report the factors associated with 90‐day mortality in a multicenter retrospective European study.

Patients/Methods

All burn patients with confirmed IFI admitted between 1^st January 2010 to 31^st December 2015 in 10 centers in France and Belgium were included.

Results

Ninety‐four patients were enrolled with 110 cases of IFIs: 79 (71.8%) were yeasts IFI and 31 (28.2%) filamentous IFI. Incidence was 1% among admitted patients. The 90‐day mortality was 37.2% for all IFIs combined, 52% for filamentous infection and 31.9% for yeast infection. Patients with more than one IFI had a higher 90‐day mortality than patients with only one episode (61.5% vs 33.5 % (P= .006)). In multivariate analysis, higher Simplified Acute Physiology Score II (OR= 1.05 (95% CI: 1.02‐1.09) P= .003), bacterial co‐infection (OR= 3.85 (95% CI: 1.23‐12.01), P= .014) and use of skin allografts at the time of IFI diagnosis (OR= 3.87 (95% CI: 1.31‐11.42), P = .021) were associated with 90‐day mortality.

Conclusions

Although rare, invasive fungal infections remain associated with poor outcome in burn patients. Bacterial coinfection and presence of allograft were potentially modifiable factors independently associated with outcome.