Correlation of culture with histopathology in fungal burn wound colonization and infection
Correlation of culture with histopathology in fungal burn wound colonization and infection
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DOI：
10.1016/j.burns.2006.08.040
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发表时间：
2007-05-01
期刊：
影响因子：
2.7
通讯作者：
Hospenthal, Duane R.
中科院分区：
文献类型：
--
作者：
Schofield, Christina M.;Murray, Clinton K.;Hospenthal, Duane R.
现在越来越多的烧伤伤口感染是由真菌引起的。从历史上看，真菌烧伤伤口感染 (FWI) 的治疗包括清创、局部抗真菌药物和/或静脉注射两性霉素 B，因此不需要对真菌烧伤伤口定植 (FWC) 与 FWI 进行进一步分类。新型抗真菌剂具有不同的活性谱，增加了识别真菌（通常是物种）的重要性。我们对 2000 年 4 月至 2005 年 3 月期间入住我们烧伤中心的患者记录进行了组织病理学鉴定真菌的审查。将含有真菌的伤口标本分类为FWC或FWI并比较培养结果。 1515 份手术伤口组织标本来自 2036 名患者。 68 名患者的组织病理学中检测到真菌，其中 19 名患者进行 FWI（3.8 FWI/年）； 9在文化上有相应的增长。 49 名患者被鉴定为 FWC，其中 16 名患者在相应培养物中恢复了真菌。 FWI 与死亡率增加相关（OR 25.3，GI 3.12-204.8）。真菌的组织病理学和培养鉴定之间的相关性不一致。 FWI 的病因多种多样；分离出对三大类抗真菌药物均具有已知耐药性的真菌，这表明凭经验使用一类抗真菌药物可能不足以治疗 FWI。未来的烧伤创面管理必须设法识别真菌病原体的种类。由 Elsevier Ltd 和 ISBI 出版。
An increasing number of burn wound infections are now due to fungi. Historically, therapy of fungal burn wound infections (FWI) consisted of debridement, topical antifungals and/or IV amphotericin B, negating the need to categorize disease further than fungal burn wound colonization (FWC) versus FWI. Newer antifungal agents have varying spectrums of activity, increasing the importance of identifying fungi, often to species. The records of patients admitted to our burn center from April 2000 to March 2005 were reviewed for fungi identified by histopathology. Wound specimens with fungi were classified as FWC or FWI and culture results were compared. The 1515 surgical wound tissue specimens were obtained from 2036 patients. Fungi were detected in the histopathology of 68 patients, 19 with FWI (3.8 FWI/year); 9 had corresponding growth on culture. Forty nine patients were identified with FWC, 16 with fungi recovered in corresponding cultures. FWI was associated with increased mortality (OR 25.3, GI 3.12-204.8). Correlation between histopathologic and culture identification of fungi was inconsistent. The etiology of FWI was diverse; fungi with known resistance to each of the three major classes of antifungals were isolated, suggesting empirical use of one class may be inadequate to treat FWI. Future burn wound management must seek to identify fungal pathogens to species. Published by Elsevier Ltd and ISBI.