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烧伤重症监护病房真菌感染的结局:一项对172例患者的研究。

The outcome of fungal infections in a burn intensive care unit: a study of 172 patients.

作者信息

Horta R, Tomaz D, Egipto P, Silva A

机构信息

Department of Plastic and Reconstructive Surgery, and Burn Unit, Centro Hospitalar de São João, Porto Medical School, Porto, Portugal.

出版信息

Ann Burns Fire Disasters. 2020 Jun 30;33(2):101-106.

Abstract

Burned patients are an especially fragile population in which infections are a leading cause of death and morbidity. Fungal infections have become increasingly prevalent in Intensive Care Units (ICUs) and burn ICUs. Management of fungal colonization and infection still constitutes a challenge for clinicians. The aim of this retrospective cross-sectional study was to characterize the population of burn patients with fungal infections admitted to our Burn ICU between January 2013 and December 2015. Patients were characterized according to age, gender, date of admission and exit, type of burn, type of exit, total body surface area (TBSA) and presence of inhalation injury. Positive fungal cultures, causative pathogen and site of sampling were also registered. Statistical analysis centred around the presence of fungal infection/colonization was performed using IBM SPSS Statistics. A total of 172 patients were included, 38 (22.1%) had a positive fungal culture and of these 8 (21.1%) died. Patients with fungal infection/colonization stayed more days than those without infection. However, this tendency did not reach statistical significance when patients that died in the ICU were excluded. No relationships were found when comparing positive fungal cultures with TBSA, burn aetiology, inhalation injury or mortality. Fungal infections are a major cause of morbidity and mortality despite TBSA, burn type or presence of inhalation injury. Efforts should be made to improve management of fungal infections, especially in burn patients and other critically ill groups.

摘要

烧伤患者是一个特别脆弱的群体,感染是导致死亡和发病的主要原因。真菌感染在重症监护病房(ICU)和烧伤ICU中日益普遍。真菌定植和感染的管理对临床医生来说仍然是一项挑战。这项回顾性横断面研究的目的是对2013年1月至2015年12月期间入住我们烧伤ICU的真菌感染烧伤患者群体进行特征描述。根据年龄、性别、入院和出院日期、烧伤类型、出院类型、全身表面积(TBSA)和吸入性损伤的存在情况对患者进行特征描述。还记录了真菌培养阳性结果、致病病原体和采样部位。使用IBM SPSS Statistics对围绕真菌感染/定植情况进行了统计分析。总共纳入了172例患者,其中38例(22.1%)真菌培养呈阳性,这其中有8例(21.1%)死亡。有真菌感染/定植的患者住院天数比没有感染的患者多。然而,当排除在ICU死亡的患者后,这种趋势没有达到统计学意义。在比较真菌培养阳性结果与TBSA、烧伤病因、吸入性损伤或死亡率时,未发现相关性。尽管有TBSA、烧伤类型或吸入性损伤的存在,真菌感染仍是发病和死亡的主要原因。应努力改善真菌感染的管理,尤其是在烧伤患者和其他重症患者群体中。

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