Natural history of bloodstream infections in a burn patient population: The importance of candidemia

Temporal trends, risk factors and outcomes in albicans and non-albicans candidaemia: an international epidemiological study in four multidisciplinary intensive care units

“…Associated mortality rates of 33-37% have been described in surgical ICU patients [9,39], whilst mortality rates of 63% and 85% have been described in patients with burn injuries and medical ICU patients, respectively [13,36]. However, as candidaemia generally occurs in patients who are profoundly debilitated, it is important to distinguish between mortality resulting from the general disease severity and mortality directly attributable to candidaemia.…”

“…The importance of candidaemia in patients with severe underlying disease or critical illnesses has become increasingly recognised; crude mortality rates range from 36% to 63% [4,[6][7][8][9][10][11][12][13][14]. Candidaemia is associated with prolonged hospital stay and has been identified as an independent predictor of death, with an attributable mortality of 5-49% [6,10,[15][16][17][18][19].…”

Predisposing factors for candidemia in patients with major burns

“…Additionally, in the present study patients with candidemia were diagnosed with a greater TBSA compared to patients without candidemia. Similarly, Ekenna and colleagues demonstrated that a larger burn size and the duration of hospitalization were risk factors for candidemia [20].…”

Burn Wound Infections

“…Endogenous gram-negative bacteria from the patient's gastrointestinal flora also rapidly colonize the burn wound surface in the first few days after injury (266,267,269,357). Wound colonization by yeasts and fungi usually occurs later due to the use of broad-spectrum antibiotic therapy (65,105,123). Microorganisms transmitted from the hospital environment tend to be more resistant to antimicrobial agents than those originating 412 CHURCH ET AL.…”

“…Burn patients with sepsis from invasive burn wound infection have transient or intermittent bacteremia or fungemia from seeding of microorganisms into the bloodstream, but positive blood cultures are a late sign of infection (41,109,123,152,270,444). Bacteremia also occurs from endogenous intestinal flora because of the decreased blood flow and gut perfusion that occur following thermal injury (248,266,371).…”