Detection of Circulating Mucorales DNA in Critically Ill Burn Patients: Preliminary Report of a Screening Strategy for Early Diagnosis and Treatment

Legrand, Matthieu; Gits-Muselli, Maud; Boutin, Louis; García-Hermoso, Dea; Maurel, Véronique; Soussi, Sabri; Benyamina, Mourad; Ferry, Axelle; Chaussard, Maïté; Hamane, Samia; Denis, Blandine; Touratier, S.; Guigue, Nicolas; Fréalle, Émilie; Jeanne, M.; Shaal, Jean-Vivien; Soler, C.; Mimoun, Maurice; Chaouat, Marc; Lafaurie, Matthieu; Mebazaa, Alexandre; Bretagne, Stéphane; Alanio, Alexandre

doi:10.1093/cid/ciw563

Cited by 87 publications

(81 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…colonisation and at least one episode of sepsis or septic shock). The included patients (n = 130) had a median age of 53 (36-66) years, with a male: female ratio of 1.54:1, with a median TBSA of 33 (18-50)%, SAPS II of 34 (23-47), ABSI of 8 (7-10) and BOBI score of 5 (3)(4)(5)(6). Of this group, 127 (97%) were mechanically ventilated and 99 (76%) received vasopressors in the first 24 hours.…”

Section: Patients' Characteristicsmentioning

confidence: 99%

“…In critically ill burns patients, infectious complications remain a major determinant of outcome . Patients with extensive burns and with early use of broad‐spectrum antibiotics are at high risk of developing infections due to multidrug‐resistant bacteria and invasive fungal infections . In this population, fungal infections are increasingly frequent and Candida spp have been reported as the most common fungal isolate .…”

Section: Introductionmentioning

confidence: 99%

“…1 Patients with extensive burns and with early use of broad-spectrum antibiotics are at high risk of developing infections due to multidrug-resistant bacteria and invasive fungal infections. 2,3 In this population, fungal infections are increasingly frequent and Candida spp have been reported as the most common fungal isolate. 4 Candidemia occurs in 2%-11% of patients with extensive burns 1,5,6 and is reported to have a high attributable mortality that can reach 41%.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Outcome and potentially modifiable risk factors for candidemia in critically ill burns patients: A matched cohort study

Dudoignon

Alanio

Anstey

et al. 2018

Mycoses

Self Cite

View full text Add to dashboard Cite

Summary Background Patients with extensive burns are at risk of developing candidemia. Objectives To identify potentially modifiable risk factors and outcomes of candidemia in critically ill burns patients. Patients and Methods Retrospective matched cohort study including adult burns patients. Patients who developed candidemia were matched with burns patients with Candida spp colonisation and sepsis or septic shock without candidemia in a ratio of 1:3 (same severity scores and colonisation index). Univariate and multiple regression analyses were performed. Results Of 130 severely burned patients with Candida spp colonisation and at least one episode of sepsis or septic shock, 14 were diagnosed with candidemia. In the candidemia group, patients had a median (IQR) total burns surface area (TBSA) of 57 (38‐68)%, SAPSII of 43 (36‐58) and ABSI of 11 (8‐13). Multiple regression analysis showed that only duration of prior antibiotic therapy was independently associated with candidemia. ICU mortality was higher in the candidemia group (71% vs 35% [P = 0.02]). The log‐rank test for 28‐day mortality comparing patients with candidemia treated with an empirical strategy vs a curative strategy did not reach significance (P = 0.056). Conclusions Burns patients having received recent antibiotherapy have a higher risk of candidemia. Antifungal strategies did not influence outcome in this series.

show abstract

Section: Patients' Characteristicsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Outcome and potentially modifiable risk factors for candidemia in critically ill burns patients: A matched cohort study

Dudoignon

Alanio

Anstey

et al. 2018

Mycoses

Self Cite

View full text Add to dashboard Cite

show abstract

“…Detection of Circulating Mucorales DNA using quantitative real-time polymerase chain reaction (qPCR) was performed on plasma as previously described. 10,11 PCR data for Mucorales detection were only available in one centre. Finally, no centre used galactomannan or ß-D-Glucan antigens detection.…”

Section: Mycological Datamentioning

confidence: 99%

“…Finally, 13 patients developed more than one IFI ( Table 3). The median delay between the first and the second IFI was 4 [2][3][4][5][6] days, and between the second and the third IFI was 8 [4][5][6][7][8][9][10][11][12] days. Patients with multiple IFIs had a higher ABSI score (13 vs 9, P = .003) and higher TBSA (60% vs 40%, P = .001) than patients with one IFI only.…”

Section: Characteristics Of Invasive Fungal Infectionsmentioning

confidence: 99%

Outcome and characteristics of invasive fungal infections in critically ill burn patients: A multicenter retrospective study

Maurel

Denis

Camby

et al. 2020

Mycoses

Self Cite

View full text Add to dashboard Cite

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 multicentre retrospective European study.Patients/Methods: All burn patients with confirmed IFI admitted between 1 January 2010 to 31 December 2015 in 10 centres 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)

show abstract

Multiple diagnostic methods for mucormycosis: A retrospective case series

Wang

Han

et al. 2022

Clinical Laboratory Analysis

View full text Add to dashboard Cite

Background Mucormycosis is a rare invasive fungal disease with high mortality. Early diagnosis and targeted drugs are crucial to improving clinical outcomes. Methods We searched the electronic hospital database of the First Affiliated Hospital of Zhejiang University School of Medicine for adult patients with mucormycosis between 2000 and 2021. Demographic, clinical, treatment, and outcome data were collected and compared with the data in the relevant literature. Results Eleven cases of mucormycosis—four of multisite infection, one of skin infection, five of lung infection, and one of gastrointestinal infection—were found and analyzed. The patients were diagnosed mainly based on pathological and histological findings, and three patients had metagenomic next‐generation sequencing findings. Delayed diagnosis (i.e., diagnosis >7 days after patient admission or >30 days after onset of symptoms) results in poor prognosis compared with early diagnosis. Conclusions Improving awareness and shortening diagnosis time may improve the prognosis of mucormycosis. If mucormycosis is suspected, appropriate samples should be collected as soon as possible and submitted for biopsy, culture, or mNGS to confirm the diagnosis.

show abstract

Detection of Circulating Mucorales DNA in Critically Ill Burn Patients: Preliminary Report of a Screening Strategy for Early Diagnosis and Treatment

Abstract: This study suggests that the detection of cmDNA allows earlier diagnosis of IWM in severely ill burn patients and earlier initiation of treatment. Further studies are needed to confirm the impact of earlier treatment initiation on patient outcome.

Cited by 87 publications

References 18 publications

Outcome and potentially modifiable risk factors for candidemia in critically ill burns patients: A matched cohort study

Outcome and potentially modifiable risk factors for candidemia in critically ill burns patients: A matched cohort study

Outcome and characteristics of invasive fungal infections in critically ill burn patients: A multicenter retrospective study

Multiple diagnostic methods for mucormycosis: A retrospective case series

Contact Info

Product

Resources

About