scholarly journals Fungal infection profile in burn patients at a tertiary care centre of India

2018 ◽  
Vol 6 (8) ◽  
pp. 2633
Author(s):  
Imran Ahmad ◽  
Mohammed Fahud Khurram ◽  
Sudheer Kumar Maurya ◽  
Rajesh Kumar Maurya ◽  
Mohd. Tafazul Sheikh
Keyword(s):  
Candida Albicans ◽  
Fungal Infection ◽  
Bacterial Infections ◽  
Late Onset ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
Fungal Culture ◽  
Burn Patients ◽  
Burn Wound ◽  
Culture Positive

Background: Burn patients are at high risk of infections and burn wound infection is one of the most important factor responsible for their morbidity and mortality. Burn patients have increased incidence of fungal infection in comparison to others. Fungal infection is difficult to diagnose because it has similar symptoms like bacterial infections. Common fungal organism causing burn wounds infections are Candida sp., Aspergillus sp., non albicans Candida, Zygomycetes etc.Methods: This prospective study was carried out in Department of Burn, Plastic and Reconstructive Surgery, J.N.M.C.H., Aligarh Muslim University, India from December 2015 to June 2017. Patients having 20 to 60% body surface area involvement with more than 5 years of age with no comorbidity were included in this study.Results: In our study, total 126 patients were included, 9 male patients (18.37%) were found fungal culture positive whereas 14 females (18.18%) were culture positive. 12 patients (9.52%) were found to be positive for Candida albicans, 6 patients (4.76%) were Aspergillus flavus positive, 3 patients (2.38%) were positive for Non Candida albicans and 2 patients (1.59%) were positive for Aspergillus niger.Conclusions: Fungal burn wound infections are one of the most common cause of late onset morbidity and mortality in burn patients. So, high level of suspicion and tissue culture are essential in making early diagnosis and treatment. Judicious use of antibiotics are also necessary for decreasing its incidence.

scholarly journals Nosocomial Infection in Burn Unit of Cipto Mangunkusumo Hospital, Jakarta

1970 ◽  
Vol 1 (3) ◽  
Author(s):  
Danu Mahandaru ◽  
Aditya Wardhana
Keyword(s):  
Nosocomial Infection ◽  
Immune Suppression ◽  
Bacterial Infections ◽  
Antimicrobial Agents ◽  
Hospital Environment ◽  
Burn Patients ◽  
Burn Wound ◽  
Medical Instruments ◽  
Burn Unit ◽  
Control Procedures

Backgrounds: Burn patients, due to the immune compromise effects of their injury have a high risk for infections. The major cause of infection is the hospital environment contamination. This study was conducted to detect and identify isolated bacteria from patients and hospital environment in the Burn Unit and determine their antibiotics pattern in response to commonly used antimicrobial agents; in order to give recommendations for management of bacterial infections and drug-resistance. Patients and Methods: Retrospective observational study was conducted reviewing the database of Burn Unit in RSCM from January until December 2010. The characteristics of microorganisms found on the burn wound were compared to those obtained from the environments such as from the air, bathing water, and medical instruments. The pattern of microorganisms and their sensitivity-resistance characteristics were noted.Result: The pattern shows that nosocomial infection in the Burn Unit of RSCM was high. Klebsiella pneumoniae found on the burn wound eschars mimics those obtained from the air within the Burn Unit. Strains of MRSA were also found on screening.Conclusion: Our findings emphasize the need for careful disinfection and more strict infection control procedures in areas that serve immune suppression individual, such as burn patients.

scholarly journals Trichosporon species isolated from scald burn wound in an immunocompetent adult: a case report from Southern Assam

2021 ◽  
Vol 9 (12) ◽  
pp. 3700
Author(s):  
Barnamoy Bhattacharjee ◽  
Debadatta D. Chanda ◽  
Atanu Chakravarty
Keyword(s):  
Fungal Infection ◽  
Bacterial Infections ◽  
Case Reports ◽  
Tertiary Care ◽  
Fungal Colonization ◽  
Trauma Patients ◽  
Sensitivity Testing ◽  
Industrial Worker ◽  
Burn Wounds ◽  
Trichosporon Species

There are quite a good number of case reports on fungal infection in burn wounds in addition to the conventionally notorious bacterial infections in immune-compromised burn trauma patients leading to protracted course of morbidity and higher chances of mortality due to delay in diagnosis. The incidence of fungal infection in burn patients has been increasing with paradigm shift of causal fungus over last 2 decades from Candida albicans and molds to non-albicans Candida, Trichosporon species and other yeast like fungus. But there are rarely few cases of invasive Trichosporon infection in scald burn wounds in immunocompetent individuals. We therefore report a case of Trichosporon species isolation from a scald burn ulcer of an immunocompetent young male industrial worker in 2nd week of its clinical course which responded to oral fluconazole followed by skin grafting since this case scenario in itself is an uncommonly presented and reported event coupled with finding of first ever case with such presentation in this tertiary care institute of Southern Assam. This case is also reported with intention of raising awareness in surgeons for keeping vigil on non-healing burn wounds with empirical antibiotics and about the need of timely pus culture and sensitivity testing to rule out fungal colonization and prevent mortality due to disseminated fungal infection.

707 Factors Associated with Early vs. Late AKI in Burn Patients

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S184-S185
Author(s):  
Jessicah A Respicio ◽  
Patrick Duffy ◽  
Tyler M Smith ◽  
Kiran U Dyamenahalli ◽  
Arek J Wiktor ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Late Onset ◽  
Total Body Surface Area ◽  
Kidney Injury ◽  
Primary Objective ◽  
Morbidity And Mortality ◽  
Burn Patients ◽  
Post Injury ◽  
Factors Associated ◽  
Total Body

Abstract Introduction Acute kidney injury (AKI) in burn patients is known to increase morbidity and mortality, with significant improvement after the initiation of renal replacement therapy (RRT). Our primary objective is to characterize the sub-population of burn patients with early (≤48 hours post-injury) versus late (>48 hours post injury) onset of AKI. We hypothesize that patients with early onset AKI versus late onset AKI have different causalities, risk factors, and outcomes. A secondary aim is to investigate the timing and use of RRT in the setting of early and late AKI with the goal of improving morbidity and mortality. Methods A retrospective cohort study was conducted on all patients admitted to a verified burn center requiring RRT for AKI from 2015 – 2019. Patients were stratified by age, gender, percent total body surface area (TBSA), race, time of onset of AKI, timing of RRT initiation, hospital LOS, pre-admission co-morbidities, admission toxicology, and mortality. Results In total, 1537 burn patients were reviewed and 1.3% (n=20) required RRT for AKI. Out of this cohort, 70% developed early AKI and 30% developed late AKI. Early versus late AKI patients had the same median age (57). Patients with larger TBSA developed early AKI (median TBSA 51%) versus late AKI (median TBSA 21%). Half of the patients who developed late AKI presented with positive alcohol toxicology screens, while 86% of patients with early AKI tested negative. The patient mortality rate in early AKI was 57%, and the mortality rate in late AKI was 17%. Only 14% of early AKI patients required dialysis at discharge, while 33% of late AKI patients required dialysis at discharge. The majority of patients started on early RRT (< 48 hours post injury) did not develop sepsis (43% developed sepsis), while the majority of patients started on late RRT (>48 hours post injury) did develop sepsis (85%). Conclusions Positivity for alcohol on admission may be a predictor for development of late AKI, while larger TBSA may predict early AKI. Mortality is higher for patients with early AKI; however, the need for dialysis at discharge is higher in patients with late AKI. Our data further suggests that early initiation of RRT is negatively correlated with the development of sepsis. Applicability of Research to Practice A deeper understanding of associations and causality of early vs late onset AKI in burn patients will help guide further management and improve outcomes.

scholarly journals The impact of systemic fungal infection in patients with perforated oesophagus

2012 ◽  
Vol 94 (8) ◽  
pp. 579-584 ◽  
Author(s):  
H Elsayed ◽  
H Shaker ◽  
I Whittle ◽  
S Hussein
Keyword(s):  
Fungal Infection ◽  
Early Stage ◽  
Significant Proportion ◽  
Poor Response ◽  
Morbidity And Mortality ◽  
Fungal Culture ◽  
Tertiary Referral Centre ◽  
Systemic Fungal Infection ◽  
Mortality And Morbidity ◽  
The Impact

INTRODUCTION Perforated oesophagus is a surgical emergency with significant morbidity and mortality. Systemic fungal infection represents a poor response to the magnitude of the insult, which adds significantly to the risk of morbidity and mortality in these patients. We reviewed our experience with this group of patients over a six-year period in a tertiary referral centre. METHODS A retrospective clinical review was conducted of patients who were admitted following a ruptured oesophagus over a period of six years (January 2002 – January 2008). RESULTS We had 27 admissions (18 men and 9 women) following an isolated perforated oesophagus to our unit. The median patient age was 65 years (range: 22–87 years). The majority (n=24,89%) presented with spontaneous perforations (Boerhaave’s syndrome) and three (11%) were iatrogenic. Fungal organisms, predominantly Candida albicans, were positively cultured in pleural or blood samples in 16 (59%) of the 27 patients. Fourteen patients grew yeasts within the first seven days while two showed a delayed growth after ten days. Overall mortality was 5 out of 27 patients (19%). There was no mortality among the group that did not grow yeasts in their blood/pleural fluid while mortality was 31% (5/16) in the group with systemic fungal infection (p<0.001). A positive fungal culture was also associated with increase ventilation time, intensive care unit stay and inpatient hospital stay but not an increased rate of complications. CONCLUSIONS Systemic fungal infection in patients with a ruptured oesophagus affects a significant proportion of these patients and carries a poor prognosis despite advanced critical care interventions. It may represent a general marker of poor host response to a major insult but can add to mortality and morbidity. It is worth considering adding antifungal therapy empirically at an early stage to antimicrobials in patients with an established diagnosis of a perforated oesophagus.

Dermoscopic Features of Toenail Onychomycosis

2020 ◽  
Vol 110 (3) ◽  
Author(s):  
Noureddine Litaiem ◽  
Ines Nakouri ◽  
Sabrine Bouhlel ◽  
Yasmine Mansour ◽  
Meriem Bouchakoua ◽  
...  
Keyword(s):  
Candida Albicans ◽  
Lichen Planus ◽  
Trichophyton Rubrum ◽  
Nail Plate ◽  
Final Diagnosis ◽  
Published Data ◽  
Fungal Culture ◽  
Proximal Margin ◽  
Culture Positive ◽  
Clinical Subtype

Background Onychomycosis is the most common infectious nail disorder. Direct mycologic examination is still the cornerstone of diagnosis; however, it may take several weeks to obtain a result. Recently some dermoscopic patterns that can be useful in the diagnosis of onychomycosis were described. However, published data on dermoscopic features of onychomycosis are still limited. Methods We performed a prospective dermoscopic study of patients with positive fungal culture between April and December 2016. Patients with a final diagnosis of psoriasis or lichen planus were excluded from the study. Dermoscopy (polarized and nonpolarized) was performed. Results Thirty-seven patients were enrolled, 24 women and 13 men (median ± SD age, 48.6 ± 16.1 years). Nail samples were culture positive for Trichophyton rubrum (89.2%), Trichophyton interdigitale (8.1%), and Candida albicans (2.7%). Distal and lateral subungual onychomycosis was the most frequent clinical subtype (59.5%). The most frequent dermoscopic features were subungual keratosis (73.0%), distal subungual longitudinal striae (70.3%), spikes of the proximal margin of an onycholytic area (59.5%), transverse superficial leukonychia (29.7%), and linear hemorrhage (13.5%). Brown chromonychia was most frequently seen with nonpolarized dermoscopy (66.6% versus 24%; P = .027). Conclusions Specific dermoscopic signs of onychomycosis are mostly related to the proximal invasion of the nail plate. Detection of these signs is simple and can, in some cases, help avoid mycologic testing.

Spectrum of Fungal Pathogens in Burn Wound Specimens: Data From a Tertiary Care Hospital Laboratory in Pakistan

2020 ◽  
Author(s):  
Kauser Jabeen ◽  
Muneeb Khan ◽  
Seema Umar ◽  
Najma Shaheen ◽  
Joveria Farooqi
Keyword(s):  
Fungal Pathogens ◽  
Fungal Infections ◽  
Fusarium Species ◽  
Tertiary Care ◽  
Care Hospital ◽  
Burn Patients ◽  
Burn Wound ◽  
Fungal Isolation ◽  
Burn Wounds ◽  
Tissue Specimens

Abstract Burn patients are at great risk of developing fungal wound infections. Fungi are frequently cultured from burn tissue specimens alone or in combination with bacteria. However, the spectrum of fungi in burn patients from Pakistan has not been reported previously. A retrospective laboratory-based study was conducted and data on all positive cultures from burn wounds were included. During the study period, specimens were cultured on appropriate media and incubated for anaerobic and aerobic growth. Clinical and demographic information recorded during clinical reporting was also collected. Seventy tissue cultures were positive for microorganisms. Of these, 27 (39%) had growth of either filamentous mold (17 cases) or Candida species (14 cases). Two cases had growth of both mold and yeast. Aspergillus flavus was the most common mold (9) followed by Fusarium species (3). Candida tropicalis was the most common yeast (7) followed by Candida parapsilosis (4). There was concomitant bacterial growth in 19 cases, predominantly of Staphylococcus aureus (13), Pseudomonas aeruginosa (8), and other Gram-negative rods (6). Of the 35 patients in which treatment history was available, 33 were receiving broad-spectrum antibiotics. A high incidence of fungal isolation was seen in this study. Their findings are consistent with the global increase in fungal infections in burn wounds. High index of suspicion by clinicians and revision of culture protocols in burn patients may be warranted for optimal patient management.

scholarly journals Prevalence and spectrum of dermatophytes in patients attending a tertiary care hospital Srinagar, Kashmir

2021 ◽  
Vol 9 (4) ◽  
pp. 1064
Author(s):  
Tabindah Jahan ◽  
Anjum Farhana ◽  
Farhat Kanth
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Age Groups ◽  
Clinical Samples ◽  
Fungal Culture ◽  
Care Hospital ◽  
Cultural Methods ◽  
Lower Socioeconomic ◽  
Fungal Distribution ◽  
Culture Positive

Background: Dermatophyte infections are a global health problem but very neglected in Kashmir. India. This work aimed at determining prevalence and spectrum of dermatophytosis isolated from patients attending tertiary care hospital Srinagar. Kashmir.Methods: A total of 510 samples of skin, hair and nail scrapings were collected and processed using standard microscopy (KOH) and cultural methods as per the standard protocol.Results: Out of 510 samples collected, 272 (53.33%) patients were confirmed cases of dermatophytosis (confirmed clinically and on fungal culture). The prevalence of dermatophytosis was significantly associated with age groups of participants with higher infection among those aged 18-32 which accounted for 35.29%, followed by age group 1-17 with 30.14%. Out of 510 samples, 110 ( 21.56%) were both KOH (microscopy) and culture positive, 162 (31.76%) cases were only culture positive and 130 (25.49%) clinical samples were only positive for fungal elements on microscopy. 133 (26.07%) fungal isolates were obtained which included both dermatophyte and non-dermatophytic fungi(excluded in this study). T. mentagrophytes had highest distribution 40.44% among dermatophytes species and T. Unguium 114 (41.96%) accounted for most common site for dermatophytic infections. Poor hygiene was predominant risk factor in 143 cases (52.57%). Patients from lower socioeconomic status were affected more than others (34.92%).Conclusions: In this study we have focused to determine the prevalence, clinical pattern and pathogenic profile of dermatophytosis according to the age, gender, site, and fungal distribution. Improvization of these conditions more accurately can result in decreased incidence of dermatophytosis in this area. 

scholarly journals Bacteriological profile and antibiotic sensitivity patterns of burn wound in delayed presenting cases of burn at a tertiary care centre in India

2018 ◽  
Vol 5 (8) ◽  
pp. 3315
Author(s):  
Mohammed Fahud Khurram ◽  
Sudheer Kumar Maurya ◽  
Rajesh Kumar Maurya ◽  
Mohammad Yaseen
Keyword(s):  
Wound Care ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Epidemiological Data ◽  
Burn Patients ◽  
Care Centre ◽  
Burn Wound ◽  
Tertiary Care Centre ◽  
Tertiary Centre ◽  
Bacteriological Profile

Background: In developing world, there is a wide gap between the number of burn patients and resources of management. Patients reports to tertiary centre late. So in our study, we have assessed the late presenting cases of burns, their epidemiological data, bacteriological profile and antibiotic sensitivity patterns of burn wounds.Methods: This is a prospective study conducted in Jawaharlal Nehru Medical College and associated hospital, Aligarh Muslim University, Aligarh from December 2015 to November 2017,where all the delayed presenting (>5 days) cases of burn involving 20% to 60% body surface area having no other comorbidity and age ranging from 5 years to 60 years were included and evaluated.Results: In our study, total 104 patients were included. Total 281 swabs were found to be culture positive, out of which 243 were monobacterial dominant. The Pseudomonas aeruginosa was found in 29.22% cases, E.coli in 23% cases, Klebsiella pneumoniae in 20.16%, Citrobacter in 9.88% cases, MRSA in 04.53%, MSSA in 5.35% cases. P.aeruginosa was mainly sensitive to piperacillin + tazobactum in 74.64%. Escherichia colli was sensitive to piperacillin + tazobactum in 75% cases, to collistin in 73.21% cases.Conclusions: Burn injuries are very common specially in developing countries where dependence over the traditional way of cooking is more. Use of antibiotic as per bacterial culture and sensitivity report, early surgical intervention and proper burn wound care at tertiary care centre reduce the morbidity and mortality of burn patients.

scholarly journals Spectrum of dermatophytes in a tertiary care centre in Northern India

2021 ◽  
Vol 8 (4) ◽  
pp. 297-301
Author(s):  
Pavneet Kaur ◽  
Guneet Awal ◽  
Amandeep Singh ◽  
Ramanjit Kaur ◽  
Parmeet Kaur
Keyword(s):  
Tertiary Care ◽  
Fungal Culture ◽  
Tertiary Care Centre ◽  
Isolation And Identification ◽  
Predisposing Factor ◽  
Early Management ◽  
Keratinized Tissue ◽  
The World ◽  
One Year ◽  
Culture Positive

Dermatophytes is major public health challenge in many parts of the world, mainly in developing countries due to poor housing facilities, high population per capita, and poor sanitary conditions. Early diagnosis and identification is must for preventing and early treatment of dermatophytosis. Also, some studies suggest that in prepubescent children there is an inadequate amount of fungi inhibiting fatty acids synthesized predisposing them to dermatophytic infections. Reduction in the synthesis of these fungistatic triglycerides in sebum premenopausal women is also seen predisposing them to infection by dermatophytes. However, low socioeconomic status along with illiteracy and overpopulation has been a main predisposing factor to dermatophytic infections in developing parts of the world. The incidence also been increased due to the rise in the number of immunocompromised patients and considerable use of broad-spectrum antibioticsEarly finding of infection is must for prevention and early management of dermatophytosis. Dermatophytes enter keratinized tissue via keratinases, which produce a dermal inflammatory response causing burning, itching and rednessTo determine prevalence of species of dermatophytes. This Study was conducted on 334 samples i.e. skin scrapings, nail clippings, and hair for fungal culture in the Mycology laboratory over a period of one year extending from December 2019 to December 2020. Specimens were cultured on modified Sabouraud's dextrose agar media containing antibiotics and incubated at 25°C and 37°C for a period of 4 weeks. Isolation and identification of various species of dermatophytes were done. A cross-sectional study was conducted on patients who came to our hospital in the department of dermatology or were referred to the department of microbiology over a period of one year extending from November 2019 to November 2020. Microbiological tests of suspected patients included potassium hydroxide (KOH) mount and fungal culture examination. Cases with culture-positive results were correlated with clinical diagnosis. In the study total of 334 samples (skin scrapings, nail clippings, and hair) were received for fungal culture in the microbiology laboratory during the study period. Samples obtained were cultured on modified Sabouraud's dextrose agar (SDA) media containing antibiotics and incubated at 25°C and 37°C for a period of 4 weeks. Species identification was performed based on colony's morphology, finding of the teased mount by using lactophenol cotton blue stain (LCB) and slide culture, and also with urea hydrolysis test as seen.The Study was performed on 334 samples received from the department of dermatology for fungal culture. Fungal elements were seen in 31% of cases and were isolated in 30% of cases. In these culture-positive cases, dermatophytes were reported in 90% cases, Candida species in 4%, and another fungus was reported in 6% cases. Trichophyton species is most commonly isolated (27.6%). Microsporum and Epidermophyton species were isolated in 5.1% cases. T. mentagrophytes was the most common fungal isolate among all the culture-positive cases.

scholarly journals Emergence of multi-drug resistant strains among bacterial isolates in burn wound swabs in a tertiary care centre, Nanded, Maharashtra, India

2017 ◽  
Vol 5 (3) ◽  
pp. 973
Author(s):  
Vimal S. Rathod ◽  
. Kasturi ◽  
Sharmila S. Raut
Keyword(s):  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Empirical Therapy ◽  
Coagulase Negative Staphylococcus ◽  
Burn Patients ◽  
Bacterial Isolates ◽  
Burn Wound ◽  
Tertiary Care Centre ◽  
Microbiological Methods ◽  
Sensitivity Pattern

Background: Infection is a major cause of morbidity and mortality among burn patients. The worldwide emergence of antimicrobial resistance among a wide variety of burn wound pathogens, particularly nosocomial isolates, limits the available therapeutic options for effective treatment of burn wound infections. The study was conducted in the department of Microbiology, Dr. S.C.G.M.C, Nanded, Maharashtra, India to determine aerobic bacterial isolates from burn wound swabs and describe their antibiogram.Methods: Two wound swabs were taken from 570 patients, cultured aerobically. The isolates were identified by standard microbiological methods and antibiotic sensitivity pattern was determined.Results: Among 570 patients, 434 (76.14%) were female and 136 (23.85%) were male. Out of the total swabs collected, 548 (96.14%) were culture positive and 36 (6.56%) were having 2 isolates. Pseudomonas aeruginosa (34.93%) was the commonest isolate followed by Staphylococcus aureus (22.77%), Klebsiella pneumoniae (13.87%), Escherichia coli (13.01%) and Coagulase negative staphylococcus (11.31%). Incidence of MRSA was 59.39% and ESBL producers were 61.46 %. Gram positive isolates were 100% sensitive to Vancomycin, Linezolid and Gram negative organisms to Imipenem.Conclusions: Routine periodic sampling of burn wounds would facilitate the selection of appropriate empirical therapy and reduce the incidence of multidrug resistant infections among burn patients.

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