Clinical and Hematological Characteristics of Patients with COVID-19 Co-infected with Bacteria

Objectives: To provide suggestions and treatment opinions by analyzing laboratory data of COVID-19 patients co-infected with bacteria. Methods: We analyzed 63 patients with COVID-19 admitted to the isolation ward of the First Affiliated Hospital of Wenzhou Medical University. COVID-19 was detected using PCR, and bacteria were identified using culture. Patients were divided into two groups, including those with and those without bacterial infections, and differences in hematologic indices between the groups were analyzed. Results: There were 63 patients with median age of 55.82 years. The average hospital stay was 22.56 days. Seven patients (11.11%) had coincident bacterial infections. Detection rates in sputum/alveolar lavage and blood were the highest, 60.52% and 21.05%, respectively. Klebsiella pneumoniae, Acinetobacter, and Stenotrophomonas maltophilia were the most common found in 31.58%, 18.42%, and 15.79%, respectively. Interleukin 6 (IL-6) levels were elevated in 84.13% of patients, while IL-10 levels were elevated in 69.84%, blood ammonia levels were elevated in 82.05%, lactate levels were elevated in 75.41%, and LDH levels were elevated in 69.84%. There were significant differences between the groups in terms of expression levels of IgG, C4, AST, LDH, IL-6, IL-10, percentage of neutrophils, percentage of lymphocytes, and platelets. Conclusions: For patients with COVID-19 suspected of having bacterial infections, empiric antibiotics should be given to cover K. pneumoniae, Acinetobacter, and S. maltophilia.

Download Full-text

Microbiome in Chronic Obstructive Pulmonary Disease: Role of Natural Products Against Microbial Pathogens

Current Medicinal Chemistry ◽

10.2174/0929867327666191213110551 ◽

2020 ◽

Vol 27 (18) ◽

pp. 2931-2948

Author(s):

Alessia Santoro ◽

Carlo Tomino ◽

Giulia Prinzi ◽

Vittorio Cardaci ◽

Massimo Fini ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Microbial Communities ◽

Pulmonary Disease ◽

Bacterial Infections ◽

Microbial Pathogens ◽

Resistant Bacteria ◽

Chronic Obstructive ◽

Detection Rates ◽

Obstructive Pulmonary Disease ◽

Lung Microbiome

The “microbiome” is the operative term to refer to a collection of all taxa constituting microbial communities, such as bacteria, archaea, fungi and protists (originally microbiota). The microbiome consists of the indigenous microbial communities and of the host environment that they inhabit. Actually, it has been shown that there is a close relationship between the microbiome and human health and disease condition. Although, initially, the lung was considered sterile, actually, the existence of a healthy lung microbiome is usually accepted. Lung microbiome changes are reported in Chronic Obstructive Pulmonary Disease (COPD) and in its exacerbation. Viral and bacterial infections of the respiratory system are a major cause of COPD exacerbations (AECOPD) leading to increased local and systemic inflammation. Detection rates of virus in AECOPD are variable between 25-62% according to the detection method. The study of human airway and lung disease virome is quite recent and still very limited. The purpose of this review is to summarize recent findings on the lung microbiome composition with a special emphasis on virome in COPD and in AECOPD. Some drugs of natural origins active against resistant bacteria and virus are described.

Download Full-text

Analysis of risk factors for determining the need for prostate biopsy in patients with negative MRI

Scientific Reports ◽

10.1038/s41598-021-83802-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Linghui Liang ◽

Feng Qi ◽

Yifei Cheng ◽

Lei Zhang ◽

Dongliang Cao ◽

...

Keyword(s):

Prostate Cancer ◽

Detection Efficiency ◽

Specific Antigen ◽

Digital Rectal Examination ◽

Multivariable Logistic Regression Analysis ◽

Detection Rates ◽

Prostate Biopsies ◽

Clinically Significant ◽

Definition Of ◽

Medical University

AbstractTo analyze the clinical characteristics of patients with negative biparametric magnetic resonance imaging (bpMRI) who didn’t need prostate biopsies (PBs). A total of 1,012 male patients who underwent PBs in the First Affiliated Hospital of Nanjing Medical University from March 2018 to November 2019, of 225 had prebiopsy negative bpMRI (defined as Prostate Imaging Reporting and Data System (PI-RADS 2.1) score less than 3). The detection efficiency of clinically significant prostate cancer (CSPCa) was assessed according to age, digital rectal examination (DRE), prostate volume (PV) on bpMRI, prostate-specific antigen (PSA) and PSA density (PSAD). The definition of CSPCa for Gleason score > 6. Univariate and multivariable logistic regression analysis were used to identify predictive factors of absent CSPCa on PBs. Moreover, absent CSPCa contained clinically insignificant prostate cancer (CIPCa) and benign result. The detection rates of present prostate cancer (PCa) and CSPCa were 27.11% and 16.44%, respectively. Patients who were diagnosed as CSPCa had an older age (P < 0.001), suspicious DRE (P < 0.001), a smaller PV (P < 0.001), higher PSA value (P = 0.008) and higher PSAD (P < 0.001) compared to the CIPCa group and benign result group. PSAD < 0.15 ng/ml/cm3 (P = 0.004) and suspicious DRE (P < 0.001) were independent predictors of absent CSPCa on BPs. The negative forecast value of bpMRI for BP detection of CSPCa increased with decreasing PSAD, mainly in patients with naive PB (P < 0.001) but not in prior negative PB patients. 25.33% of the men had the combination of negative bpMRI, PSAD < 0.15 ng/ml/cm3 and PB naive, and none had CSPCa on repeat PBs. The incidence of PB was determined, CSPCa was 1.59%, 0% and 16.67% in patients with negative bpMRI and PSAD < 0.15 ng/ml/cm3, patients with negative bpMRI, PSAD < 0.15 ng/ml/cm3 and biopsy naive and patients with negative bpMRI, PSAD < 0.15 ng/ml/cm3 and prior negative PB, separately. We found that a part of patients with negative bpMRI, a younger age, no suspicious DRE and PSAD < 0.15 ng/ml/cm3 may securely avoid PBs. Conversely PB should be considered in patients regardless of negative bpMRI, especially who with a greater age, obviously suspicious DRE, significantly increased PSA value, a significantly small PV on MRI and PSAD > 0.15 ng/ml/cm3.

Download Full-text

Singular Neurectomy Update

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348948209100501 ◽

1982 ◽

Vol 91 (5) ◽

pp. 469-473 ◽

Cited By ~ 16

Author(s):

Richard R. Gacek

Keyword(s):

Middle Ear ◽

Benign Paroxysmal Positional Vertigo ◽

Anatomical Variation ◽

Complete Relief ◽

Average Hospital Stay ◽

Ablation Procedure ◽

Work Time ◽

Average Hospital ◽

Positional Vertigo ◽

Paroxysmal Positional Vertigo

The results of a poll revealed that 96 singular neurectomies have been performed by ten surgeons in this country. Eighty-eight of these (91.7%) resulted in complete relief of benign paroxysmal positional vertigo (BPPV). In seven patients (7.3%) there was a sensorineural hearing loss as a result of this procedure. The average hospital stay for patients having this procedure ranged from 2–6 days, and the return to work time ranged from 1 to 3 weeks. These results indicate that singular neurectomy is an effective selective vestibular ablation procedure for BPPV and that the risks and disability are comparable to other routine middle ear procedures. The causes for failure of this procedure to relieve positional vertigo are a) misdiagnosis of BPPV and b) failure to recognize the singular nerve in the middle ear. Knowledge of the pathophysiology of the disorder and of the anatomical variation in the location of the singular canal will reduce these causes of failure.

Download Full-text

Unimed Recife's experience in treating 1,039 patients with Covid-19

Avanços em Medicina ◽

10.52329/avanmed.4 ◽

2021 ◽

Author(s):

Marcelo Moraes Valença ◽

Martha Maria Romeiro Figueiroa F. Fonseca ◽

Cátia Arcuri Branco ◽

Alex Maurício Garcia Santos ◽

Antonio Oliveira ◽

...

Keyword(s):

Health Management ◽

Demographic Data ◽

The Elderly ◽

Obese Patients ◽

Mechanical Ventilator ◽

Average Hospital Stay ◽

Average Hospital ◽

Management Platform ◽

Pathophysiological Process ◽

Number Of Patients

ObjectiveTo describe the features related to patients with Covid-19 admitted to Unimed Recife hospitals, Recife, Brazil, evaluating demographic data, lethality, use of a mechanical ventilator, presence of associated diseases, the need to use the ICU, among other aspects related to the prognosis of these patients.MethodData were collected from the DRG Brazil health management platform, including the period from March 16, 2020, when the first patient with Covid-19 was admitted to the Hospital da Unimed III, until January 31, 2021. All patients admitted to one of the three hospitals of Unimed Recife - Hospital Unimed Recife I, Hospital Unimed Recife III, and Hospital Geral Unimed Recife – were included in the study. In the same period, we evaluated the number of patients with Covid-19 or suspected Covid-19 who were seen in the emergency room at Hospital Unimed Recife III.ResultsOne hundred twenty-six thousand five hundred fifty-three patients were seen in the Emergency Unit of Hospital Unimed Recife III in the period between March 26, 2020, and January 31, 2021; of those 126,553 patients seen in the emergency 39,340 (31.09%) patients were diagnosed with having Covid-19 or suspected of Covid-19. In the 10-month period, 1,039 patients with Covid-19 were hospitalized, 61% with hypertension, 31.1% with SARS, 30.0% with diabetes, and 9.9% were obese. The average hospital stay was 11.2 days. 342/1,039 (32.9%) patients were admitted to the ICU, and 57.9% of them had mechanical ventilation. The overall lethality was 13.76% (143 deaths/1,039 inpatients). An increase in lethality by Covid-19 was associated with increased age. Lethality in the first period of the Covid-19 pandemic was significantly higher when compared to the last 5 months of the pandemic(17.6% versus 9.7%). Obesity significantly increased lethality in patients with Covid-19 [120 deaths/1,016 non-obese patients (11.8%) versus 23 deaths/103 obese patients (22.3%), OR 2.15 (1.30 - 3.50), p = 0.005)].ConclusionWe conclude that Covid-19 is a disease with a poor prognosis, especially in the elderly and obese patients. In the second 5-month period of the Covid-19 pandemic, we noticed a significant reduction in lethality by Covid-19 in hospitalized patients. Covid-19 is a new disease and the mechanism by which the viruses multiply or how the pathophysiological process occurs in the infected organism are still barely understood.

Download Full-text

PLACENTA PREVIA

The Professional Medical Journal ◽

10.29309/tpmj/2009.16.01.3003 ◽

2009 ◽

Vol 16 (01) ◽

pp. 139-144

Author(s):

ZOONA SAEED ◽

M. Saeed ◽

M. IKRAM ◽

Roohi Saeed ◽

SHAZIA TAZIAN

Keyword(s):

Placenta Previa ◽

Previous History ◽

Average Hospital Stay ◽

Short Term ◽

Average Hospital ◽

Intraoperative Complication ◽

Causative Factors ◽

History Of ◽

Rising Incidence ◽

Post Graduate Institute

Objectives: To analyze the causative factors and short term complications in cases of placenta previa. D e s i g n a ndSettings: A retrospective study carried out in Obstetrics and Gynecology Department of Sheikh Zayed Post Graduate Institute Lahore.P e r i o d : From June 2004 to June 2007.Subject: Fifty patients with placenta previa. M a i n o u t c o m e m e a s u r e s : Age, parity, previouscesarean section, previous history of evacuation/myomectomy, average hospital stay, need for blood transfusions, emergency/electiveLSCS, associated maternal and fetal morbidity and mortality. Results: There were 50 cases of placenta previa over the period of 3 years.Most frequently occurring intra operative complication was postpartum hemorrhage in 19 patients (38%). Highest morbidity was due toanemia which was in 23 patients (46%). Maternal mortality was 2%, while neonatal mortality was 14%. C o n c l u s i o n : Placenta previa is amultifactorial disease. No doubt that the rising incidence of cesarean section is increasing the intraoperative complication associated withthe condition but other risk factors are also important like age, parity, history of evacuation etc.

Download Full-text

Insuficiência renal aguda no Nordeste brasileiro: morbimortalidade e custos públicos

Revista de Enfermagem UFPE on line ◽

10.5205/1981-8963.2019.240825 ◽

2019 ◽

Vol 13 ◽

Author(s):

Edison Vitório de Souza Júnior ◽

Diego Pires Cruz ◽

Gabriel Aguiar Nunes ◽

Giovanna Maria Nascimento Caricchio ◽

Sávio Luiz Ferreira Moreira ◽

...

Keyword(s):

Hospital Stay ◽

Kidney Diseases ◽

Northeastern Brazil ◽

Average Hospital Stay ◽

Average Hospital ◽

Average Value ◽

Hospital Morbidity ◽

Public Costs ◽

Care Costs ◽

Sistemas De Informacion

Objetivo: descrever a morbimortalidade hospitalar e custos públicos relacionados à insuficiência renal aguda no Nordeste brasileiro. Método: trata-se de estudo quantitativo, ecológico e descritivo realizado com dados do Sistema de Informações Hospitalares. Coletaram-se as variáveis: internações; óbitos; mortalidade; valores dos serviços hospitalares; valores médios gastos com as internações e média de permanência hospitalar. Analisaram-se os dados com estatística descritiva, apresentando-os em tabelas elaboradas pelo software Excel. Resultados: registraram-se 21.100 internações, 4.460 óbitos e mortalidade de 21,1%. Destacaram-se a Bahia nas internações (28,6%) e óbitos (28,7%) e Sergipe na letalidade (35,6%). Gerou-se custo público superior a R$ 37,6 milhões e a Bahia responsabilizou-se por 32,1%. Revelou-se valor médio de R$ 1.969,97 para cada internação e a média de permanência hospitalar foi de 10,2 dias. Conclusão: conclui-se que as variáveis epidemiológicas apresentaram maior prevalência nos Estados da Bahia e Sergipe. Evidenciou-se, além disso, comportamento crescente das internações, implicando o incremento dos custos públicos. Descritores: Saúde Pública; Nefrologia; Nefropatias; Epidemiologia; Custos de Cuidados de Saúde; Sistemas de Informação. Abstract Objective: to describe hospital morbidity and mortality and public costs related to acute renal failure in northeastern Brazil. Method: this is a quantitative, ecological and descriptive study conducted with data from the Hospital Information System. The following variables were collected: hospitalizations; deaths; mortality; values of hospital services; average values spent on hospitalizations and average hospital stay. Data was analyzed with descriptive statistics and presented in tables prepared by Excel software. Results: 21,100 hospitalizations, 4,460 deaths and 21.1% mortality were registered. Bahia stood out in hospitalizations (28.6%) and deaths (28.7%) and Sergipe in lethality (35.6%). It generated a public cost over R $ 37.6 million and Bahia accounted for 32.1%. An average value of R $ 1,969.97 was revealed for each hospitalization and the average hospital stay was 10.2 days. Conclusion: it is concluded that the epidemiological variables were more prevalent in the states of Bahia and Sergipe. In addition, the increasing behavior of hospitalizations was evidenced, implying an increase in public costs. Descriptors: Public Health; Nephrology; Kidney Diseases; Epidemiology; Health Care Costs; Information Systems.Resumen Objetivo: describir la morbimortalidad hospitalaria y los costos públicos relacionados con la Insuficiencia Renal Aguda en el Noreste de Brasil. Método: se trata de un estudio cuantitativo, ecológico y descriptivo realizado con datos del Sistema de Informaciones Hospitalarias. Se recogieron las siguientes variables: hospitalizaciones; muertes, mortalidad, valores de los servicios hospitalarios; promedio de valores gastados en admisiones y promedio de permanencia hospitalaria. Los datos se analizaron con estadísticas descriptivas y se presentaron en tablas elaboradas por el software Excel. Resultados: se registraron 21.100 admisiones, 4.460 muertes y 21.1% de mortalidad. Bahía se destacó en hospitalizaciones (28.6%) y muertes (28.7%), y Sergipe en letalidad (35.6%). Se generó un costo público de más de R$ 37,6 millones y Bahía fue responsable del 32.1%. El valor medio de R $ 1,969.97 se reveló para cada hospitalización y la permanencia hospitalaria con promedio de 10,2 días. Conclusión: se concluye que las variables epidemiológicas presentaron mayor prevalencia en los Estados de Bahía y Sergipe. Además, hubo evidencia de un mayor comportamiento de hospitalización, lo que implica un aumento en los costos públicos. Descriptores: Salud Pública; Nefrología; Enfermedades Renales; Epidemiología; Costos de la Atención en Salud; Sistemas de Información.

Download Full-text

REDUCING THE LITERAL AND HUMAN COST OF CHILD ABUSE: IMPACT OF A NEW HOSPITAL MANAGEMENT SYSTEM

PEDIATRICS ◽

10.1542/peds.51.5.840 ◽

1973 ◽

Vol 51 (5) ◽

pp. 840-848

Author(s):

Eli H. Newberger ◽

John J. Hagenbuch ◽

Nancy B. Ebeling ◽

Elizabeth Pivchik Colligan ◽

Jane S. Sheehan ◽

...

Keyword(s):

Child Abuse ◽

Hospital Stay ◽

Hospital Cost ◽

Hospital Costs ◽

Average Hospital Stay ◽

Total Hospital ◽

Average Hospital ◽

Consultation Group ◽

Human Cost ◽

Hospital Management System

Social service personnel from one public and two voluntary agencies were integrated into a consultation group in an academic pediatric hospital, leading to a reduction in the actual cost of medical services and the risk of reinjury subsequent to the diagnosis of child abuse. In the 1969-1970 hospital year, 62 cases of child abuse were seen, of which 39 were hospitalized. The average hospital stay was 29 days; the average hospital cost $3,000. Total hospital costs for the 39 cases were $123,000, of which bed costs made up $95,000. There were at least three subsequent incidents of child abuse in these 39 cases, and there was one subsequent death; the reinjury rate was 10% for hospitalized cases. In September 1970 the Trauma X Group, an interdisciplinary, interagency consultation unit based in the hospital, was formed. With formal consultation and continued surveillance after discharge by the Trauma X Group, the following data were obtained from the 1970-1971 hospital year. Of 86 cases, 60 were hospitalized. The average hospital stay was 17 days; the average hospital cost $2,500. Total hospital costs for the 60 cases was $150,000, of which bed costs made up $101,000. There was one incident of reinjury and no deaths subsequent to diagnosis in these 60 cases; the reinjury rate was 1.7%. The risk of reinjury calculated from a modified life table was reduced from 8% in the year previous to the formation of the group to 7% and 2%, respectively, in the subsequent year and six-month periods, supporting the dollar-cost impression of effectiveness. Foster placement, furthermore, was infrequent and does not explain the differential impact of the Trauma X Group in the intervals under study.

Download Full-text

Blood transfusion practices in upper gastrointestinal bleeding: response to a landmark study

Journal of Investigative Medicine ◽

10.1136/jim-2019-001199 ◽

2020 ◽

Vol 68 (4) ◽

pp. 882-887

Author(s):

Cameron B Wilhoit ◽

Nathan D Holman ◽

Don C Rockey

Keyword(s):

South Carolina ◽

Gastrointestinal Bleeding ◽

Laboratory Data ◽

Transfusion Practice ◽

University Of South Carolina ◽

Significant Difference ◽

Medical University ◽

Upper Gastrointestinal ◽

Rbc Transfusion ◽

Landmark Study

ObjectiveLack of clear evidence in red blood cell (RBC) transfusion during gastrointestinal bleeding has led to varied recommendations over the years. However, studies in broad areas of medicine have provided evidence about appropriate RBC transfusion thresholds, and a ‘landmark’ study published in 2013 provided evidence in patients with upper gastrointestinal (UGI) bleeding. We hypothesized that the response to the evidence would lead to improved RBC transfusion practice. Our aim was to determine the response in RBC transfusion practices at our institution.DesignWe examined RBC transfusion practices in patients with UGI bleeding who presented to the Medical University of South Carolina from January 2010 through December 2013. We abstracted extensive clinical data including demographic, medical history (comorbidities), medications, physical examination findings, laboratory data, endoscopic data, and RBC transfusion practices. We considered appropriate RBC transfusion to have occurred when performed for a hemoglobin level of <70 g/L.Results270 patients hospitalized with UGI bleeding had 606 RBC transfusions; 355 transfusions in 107 patients were appropriate, and 251 transfusions in 163 were inappropriate. In 2010, 2011, and 2012, the rates of appropriate RBC transfusions were 61/124 (49%), 92/172 (53%), and 84/142 (59%), respectively. There was a statistically significant difference in appropriate transfusions in 2013 (118/168 (70%)) compared with 2012 (84/142 (59%), p=0.003), as well as during 2010–2012 (237/438 (54%), p≤0.003).ConclusionsThe data suggest that there was an improvement in RBC transfusion practices after a landmark study. However, the data also highlight that RBC transfusion practices in UGI bleeding remain imperfect.

Download Full-text

Pancreatoduodenectomy for Periampullary Tumors Presenting with Acute Pancreatitis

Gastroenterology Research and Practice ◽

10.1155/2020/7246895 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Xuefeng Cao ◽

Xixiu Wang ◽

Xiaoliang Xu ◽

Yanmin Lu ◽

Baolei Zhao ◽

...

Keyword(s):

Acute Pancreatitis ◽

Operative Time ◽

Laboratory Data ◽

Biliary Fistula ◽

University Hospital ◽

Control Group ◽

Study Group ◽

Course Of Disease ◽

Periampullary Tumors ◽

Medical University

Background. Periampullary tumors (PT) may rarely present as acute pancreatitis (AP) or acute recurrent pancreatitis (ARP). Unlike other cases of AP and ARP, these conditions necessitate pancreaticoduodenectomy (PD), and timely diagnosis is crucial. Materials and Methods. A retrospective review of clinical, radiological, surgical, and pathological data was conducted for patients admitted to the Binzhou Medical University Hospital during the period from January 2010 to December 2017, for AP or ARP caused by PT. All patients included in the study group had undergone PD. The perioperative data for these patients was compared with data for patients with PT but without AP or ARP who underwent PD during the same period (control group). Results. During the study period, 412 patients with AP or ARP were treated; among this group, 15 patients had PT. Compared with controls, patients in the study group were younger in age and had a longer course of disease, more frequent hospitalizations, and more severe derangements in laboratory data (P<0.05). Operative time and intraoperative blood loss were significantly higher in the study group, but the incidence of postoperative outcomes such as pancreatic/biliary fistula, abdominal infection, postoperative hospital stay, and mortality were similar between groups (P>0.05). Conclusions. Neither AP nor ARP has any adverse impact on the outcomes of PD. However, in the treatment of younger patients suffering from AP or ARP, unexplained pancreatic duct dilation and weight loss should raise the suspicion of PT. EUS and EUS-FNA may be helpful in making the diagnosis.

Download Full-text

508 Fungal Infections in Burn Patients from 2014–2019: A 5-year Retrospective Review

Journal of Burn Care & Research ◽

10.1093/jbcr/iraa024.140 ◽

2020 ◽

Vol 41 (Supplement_1) ◽

pp. S90-S91

Author(s):

Kaitlin A Pruskowski ◽

Julie A Rizzo ◽

Leopoldo C Cancio

Keyword(s):

Mortality Rate ◽

High Mortality ◽

Bacterial Infections ◽

Burn Injury ◽

Fungal Infections ◽

Early Recognition ◽

Hospital Length Of Stay ◽

Burn Patients ◽

Average Hospital ◽

Time From Injury

Abstract Introduction Topical and systemic antibiotic agents used to treat burn wounds allow for fungal growth. Fungal infections often occur later in the hospital course and carry a higher mortality rate than bacterial infections in critically ill burn patients. The primary objective of this study was to describe the incidence and characteristics of fungal infections in our burn center. Methods This was a retrospective chart review. Subjects who were admitted between January 2014 and February 2019 after sustaining a burn injury and received a systemic antifungal agent were included. All cultures and histopathology results that were positive for fungus were recorded. Results Ninety one subjects were included in this analysis. The average age was 42.3±16.9 years and 74 (81.3%) subjects were male. Seventy four (81.3%) subjects were admitted after flame burn. The average burn size was 40.1±24.2% TBSA. The average hospital length of stay was 57.2±44.8 days. Thirty eight (41.7%) subjects died during their hospital stay. The 91 subjects had 220 cultures positive for fungi: 29 blood cultures, 19 BAL cultures, 23 sputum cultures, 118 tissue cultures, and 31 urine cultures. The most common fungal genera isolated were: Candida (n=146), Aspergillus (n=55), and Fusarium (n=44). Twenty six (28.6%) subjects had histopathology results that showed fungus in non-viable tissue, with an average time from injury to fungus of 20.4±11.8 days. Twenty six (28.6%) subjects had histopathology results that showed fungus in viable tissue, with an average time from injury to fungus of 22.7±16.7 days. Of note, these were not the group that had fungus in non-viable tissue. Twelve (13.2%) subjects had angioinvasion, with an average time to angioinvasion of 26.6±22 days. The 91 subjects received 133 courses of antifungals. The average course of antifungal therapy was 7.8±8.9 days. The most common antifungals used were: micafungin (n=54), fluconazole (n=53), and liposomal amphotericin B (n=44). Conclusions Patients who were started on a systemic antifungal had a high mortality rate. Common fungi isolated included Candida and Aspergillus, which is consistent with previous literature. Further research is needed on the early recognition, accurate diagnosis, and timely management of fungal infections in this patient population. Applicability of Research to Practice Fungal infections after burn injury carry a high mortality rate. Early recognition and timely management of these infections is paramount.

Download Full-text