Fusarium isolates in burn-injured patients: Clinical characteristics and susceptibility patterns
Introduction/Objective: Fusarium species are ubiquitous in the environment and can cause opportunistic infection in burn-injured patients. The purpose of this retrospective cohort observational study is to characterize Fusarium susceptibilities, antifungal and surgical management, and the effect on...
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Elsevier
2025-07-01
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| author | Robyn Stoianovici Sierra Young Jeremiah J. Duby Naomi Hauser Erin Louie |
| author_facet | Robyn Stoianovici Sierra Young Jeremiah J. Duby Naomi Hauser Erin Louie |
| author_sort | Robyn Stoianovici |
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| description | Introduction/Objective: Fusarium species are ubiquitous in the environment and can cause opportunistic infection in burn-injured patients. The purpose of this retrospective cohort observational study is to characterize Fusarium susceptibilities, antifungal and surgical management, and the effect on survival in this patient population. Methods: All burn ICU patients with a positive Fusarium culture were retrospectively identified between November 2017 to June 2023 at a regional burn center. Demographic, clinical, and microbiologic susceptibility data was collected from the electronic medication record. Results: Eighteen patients with positive Fusarium wound cultures were included. The median age was 35 (32–41) years and 28 % were female. The average %TBSA was 55 ± 23 % and r-Baux score of 93 ± 22. The most common mechanism of injury was thermal burn (17 patients, 94 %). This cohort experienced prolonged ICU [53 (46–95) days] and hospital [57 (48– 97) days] lengths of stay. The median time from burn injury to positive Fusarium cultures was 18 (14–24) days. Mechanical ventilation was common (94 %) and prolonged [42 (34–55) days]. Sixty percent of isolates resulted with a minimal inhibitory concentration (MIC) ≥ 16 mcg/ml for voriconazole and 93 % isolates resulted with an MIC < 1 mcg/ml for amphotericin B. All patients underwent surgical debridement for source control. Ten of 18 patients (55 %) with Fusarium-positive infections survived to hospital discharge. Infection complicated by multisystem organ failure and sepsis was the most common attributable cause of death (88 %). Conclusion: Patients infected with Fusarium were severely burned, critically ill, and exposed to prolonged mechanical ventilation and to central venous catheterization. The high mortality rate associated with Fusarium infection and prolonged time to antifungal susceptibility results emphasize the importance of appropriate empiric therapy. |
| format | Article |
| id | doaj-art-ca0d7098fb904c4bb206bc0d5fd46be4 |
| institution | Kabale University |
| issn | 2468-9122 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Burns Open |
| spelling | doaj-art-ca0d7098fb904c4bb206bc0d5fd46be42025-08-20T03:29:18ZengElsevierBurns Open2468-91222025-07-011110040710.1016/j.burnso.2025.100407Fusarium isolates in burn-injured patients: Clinical characteristics and susceptibility patternsRobyn Stoianovici0Sierra Young1Jeremiah J. Duby2Naomi Hauser3Erin Louie4Department of Pharmacy Services, UC Davis Medical Center, Sacramento, CA, USA; Corresponding author.Department of Pharmacy Services, UC Davis Medical Center, Sacramento, CA, USADepartment of Pharmacy Services, UC Davis Medical Center, Sacramento, CA, USADepartment of Internal Medicine, Division of Infectious Diseases, UC Davis Health, Sacramento, CA, USADepartment of Pharmacy Services, UC Davis Medical Center, Sacramento, CA, USAIntroduction/Objective: Fusarium species are ubiquitous in the environment and can cause opportunistic infection in burn-injured patients. The purpose of this retrospective cohort observational study is to characterize Fusarium susceptibilities, antifungal and surgical management, and the effect on survival in this patient population. Methods: All burn ICU patients with a positive Fusarium culture were retrospectively identified between November 2017 to June 2023 at a regional burn center. Demographic, clinical, and microbiologic susceptibility data was collected from the electronic medication record. Results: Eighteen patients with positive Fusarium wound cultures were included. The median age was 35 (32–41) years and 28 % were female. The average %TBSA was 55 ± 23 % and r-Baux score of 93 ± 22. The most common mechanism of injury was thermal burn (17 patients, 94 %). This cohort experienced prolonged ICU [53 (46–95) days] and hospital [57 (48– 97) days] lengths of stay. The median time from burn injury to positive Fusarium cultures was 18 (14–24) days. Mechanical ventilation was common (94 %) and prolonged [42 (34–55) days]. Sixty percent of isolates resulted with a minimal inhibitory concentration (MIC) ≥ 16 mcg/ml for voriconazole and 93 % isolates resulted with an MIC < 1 mcg/ml for amphotericin B. All patients underwent surgical debridement for source control. Ten of 18 patients (55 %) with Fusarium-positive infections survived to hospital discharge. Infection complicated by multisystem organ failure and sepsis was the most common attributable cause of death (88 %). Conclusion: Patients infected with Fusarium were severely burned, critically ill, and exposed to prolonged mechanical ventilation and to central venous catheterization. The high mortality rate associated with Fusarium infection and prolonged time to antifungal susceptibility results emphasize the importance of appropriate empiric therapy.http://www.sciencedirect.com/science/article/pii/S246891222500015XFusariumVoriconazoleAmphotericin BBurn |
| spellingShingle | Robyn Stoianovici Sierra Young Jeremiah J. Duby Naomi Hauser Erin Louie Fusarium isolates in burn-injured patients: Clinical characteristics and susceptibility patterns Burns Open Fusarium Voriconazole Amphotericin B Burn |
| title | Fusarium isolates in burn-injured patients: Clinical characteristics and susceptibility patterns |
| title_full | Fusarium isolates in burn-injured patients: Clinical characteristics and susceptibility patterns |
| title_fullStr | Fusarium isolates in burn-injured patients: Clinical characteristics and susceptibility patterns |
| title_full_unstemmed | Fusarium isolates in burn-injured patients: Clinical characteristics and susceptibility patterns |
| title_short | Fusarium isolates in burn-injured patients: Clinical characteristics and susceptibility patterns |
| title_sort | fusarium isolates in burn injured patients clinical characteristics and susceptibility patterns |
| topic | Fusarium Voriconazole Amphotericin B Burn |
| url | http://www.sciencedirect.com/science/article/pii/S246891222500015X |
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