Dr Lucy Aitchison1, Dr Morgan Haines1, Dr Henry Shepherd1, Dr Aruna Wijewardena1, Dr Robert Gates1
1Royal North Shore Hospital, St Leonards, Australia
Purpose: To describe the epidemiological, microbiological and clinical aspects of burns patients with systemic fungal infections at our institution.
Methodology: A retrospective observational study of systemic fungal infections in the past 5 years at a large tertiary burns unit in Sydney Australia from 2013 to 2017.
Results: From 1570 burns patients treated at our centre, 12 were identified with systemic fungal infections. The incidence of systemic fungal infections in burns patients was 0.0076). 3/12 (25%) died within the same admission. 11/12 patients had multiple body sites culture positive. 25% were positive in 3 or more sites including the urine, respiratory tract, wound or central lines. Of note, 58% of cases did not have fungi isolated from wound swabs. The most common fungal species identified were candida albicans (43%). 67% of patients had 2 or more fungal species identified in 1 or more site.
Conclusion: Systemic fungal infections are a rare but severe complication in burns patients, and remain a clinical challenge. The source of systemic fungal infection in more than half of patients appears not to be from the burn wounds themselves from rather from central lines, urinary and respiratory tracts. Clinicians should bear a high index of suspicion in patients with multiple risk factors, send early and appropriately collected cultures, and review in-dwelling devices regularly.
– RMO at Royal North Shore Hospital, Sydney, working with the Severe Burns Unit – a large burns trauma service in NSW