Identification of Fungal Pathogens in Burns Patients With Reference to Candida

Abstract

BACKGROUND: Infection with microbes in burns patients is a leading cause of morbidity and mortality. The present study was aimed to study the fungal pathogens from infected burns patients periodically during their stay in the hospital from wound surface, blood and intravascular devices and to identify and differentiate candida species. METHODS: This hospital based study was conducted during June 2011 to May 2013. Patients with greater than 25-30% burns of total body surface area (TBSA) and hospitalized in burns unit for a minimal duration of hospitalization of 7 days were included in the study. Specimens such as wound swabs, blood and intra vascular devices were collected at the end of 1 st ,2 nd , 3 rd and 4 th week, processing, isolation, identification and antibiogram of the isolates were done as per standard procedures. RESULTS: To analyze the systemic fungal infection in burn patient's Seven hundred and eight (708) blood cultures were collected and processed at regular intervals with isolation of 54 (7.6%) pathogens. Findings clearly indicates C.albicans as the most common pathogen 32 (59.26%) isolated followed by non-albicans group. In non-albicans group C.tropicalis was the most common followed by C.parapsoliasis and rest is C. krusei, C. kefyr, C. glabrata and C. guillermondii. Intravascular devices also act as sources for the systemic invasion of pathogens, Eight hundred and eighty four (884) IVD's were processed with isolation of 42(4.8%) pathogens. We found that C.albicans was the most common isolate 71.43% (30) followed by non-albicans group. In nonalbicans group C.tropicalis (6) was the common followed in the order of C. parapsoliasis (4), C.krusei (1) and C. guillermondii. CONCLUSION: We highlighted the incidence of fungal wound infection is increasing due to wide spectrum antibiotic administration. Candida albicans was the common pathogen isolated from all the specimens followed by C.tropicalis and C.parapsoliasis. Next common fungus isolated was Aspergillus spp which was further confirmed by histopathological correlation. Patients with fungal wound infection had long duration of hospital stay and systemic invasion had more mortality. Continuous surveillance of microorganisms and their antibiotic resistance can improve the efficacy of infection control programs in a burn unit.

The occurrence of fungi from burn wound patients and antifungal susceptibility patterns: a cross-sectional study in Lusaka, Zambia

“…Burn Wound Infection (BWI) remains a major public health problem and a cause of devastating trauma that can induce immediate immunosuppression which may attract predisposition to infectious complications. There has been noticeable improvement in outcomes of burn wound patients, attributed to fluid resuscitation, nutritional support and general advanced use of barrier nursing and antimicrobial agents 2 . This however, is still in contrast to opportunistic fungal infections in burn wounds patients that have been reported to be on an upswing 2 , 3 , 4 , 32 .…”

“…There has been noticeable improvement in outcomes of burn wound patients, attributed to fluid resuscitation, nutritional support and general advanced use of barrier nursing and antimicrobial agents 2 . This however, is still in contrast to opportunistic fungal infections in burn wounds patients that have been reported to be on an upswing 2 , 3 , 4 , 32 .…”

“…There has been noticeable improvement in outcomes of burn wound patients, attributed to fluid resuscitation, nutritional support and general advanced use of barrier nursing and antimicrobial agents 2 . This however, is still in contrast to opportunistic fungal infections in burn wounds patients that have been reported to be on an upswing 2,3,4,32 . The skin provides an important immune barrier and if damaged, it may result in suppression of local and systemic host cellular and humoral immune responses that can destroy circulatory immune factors and result in severe opportunistic infectious complications 5,6,7 .…”

Fungal Infection in Burns – A Prospective Study in Rural India

“…Burn wound infection is the most devastating trauma and a serious public health issue 3 . As a result of effective and easy availability of antibiotics, the incidence of bacterial infections in burns patients were reduced and the rise of fungal infections have been witnessed 4 . The main risk factors for fungal infections in burns patients are burned total body surface area and perturbed immunity.…”