Background:
@EN Invasive candidiasis is a life-threatening problem for immunosuppressed patients, such as burn patients, those undergoing transplantation. AIDS patients, and cancer patients. Frequent use of broad-spectrum antibiotics, multiple invasive
catheters,
and more recently, intravenous hyperalimentation, predispose severely burned patients to this fungal infection.
@ES Study Design:
@EN The major burn patients who had Candida organisms in the blood were studied over a period of two years ('93-'94). The patients were divided into two groups, one who had conventional therapy('93), and another who had intensive therapy('94)
with
early
detection and with new antibiotics. The mortalities of each groups were evaluated as regard to age, mode of injury, residual burn area, and treatments.
@ES Results:
@EN Of 1793 burn patients, 33 patients(1.8%) showed Candida in their blood culture. There were two peaks of blood culture positivity for Candida, which were post-burn 3rd week and 5 week. Candidemia was more prevalent in flame burns (2.3%,
p=0.01,
Odd
ratio =5.8) and in electric burns (4.2%, p=0.01, Odd ratio=6.3) than in scalding burns(0.4%). The mortality of patients of Candidemia correlated with residual raw burned surface area (r=0.9, p=0.3). With careful monitoring and intensive treatment
for
Candidemia have de creased the mortality markedly (mortality: '93 ; 50%, '94 ; 9.5%, p=0.015, Odd ratio=9.5).
@ES Conclusion:
@EN Disseminated fungal infection have represented an increasing cause of septic death in major burn patients. The use of early detection and intensive treatment techniques should decrease mortality of candidemia patients.
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