Volume 8, Issue 1 (2019)                   WJPS 2019, 8(1): 18-24 | Back to browse issues page


XML Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Jachec S, Perbix W, Fuchs P, Lefering R, Weinand C. Candida Antigen Titer Elevation and Mortality in Burn Patients. WJPS 2019; 8 (1) :18-24
URL: http://wjps.ir/article-1-427-en.html
1- Klinikum Bayreuth GmbH Sektion Plastische und Handchirurgie/Klinik II
2- Klinik für Plastische und Ästhetische Chirurgie, Kliniken der Stadt Köln, Universität Witten-Herdecke
3- Insitut für Forschung in der operativen Medizin, Universität Witten-Herdecke
4- Helios Klinikum Gifhorn, Klinik für Plastische, Rekonstruktive und Ästhetische Medizin, Handchirurgie, Verbrennungen, Universität Witten-Herdecke , chwscot@yahoo.com
Abstract:   (4804 Views)
BACKGROUND
Mortality in burn patients has several contributing factors as sex, age, degree of burns, or inhalation injuries. Usefulness of Candida antigen (CAG) titer is still being under debate to predict mortality. This study assessed correlation between CAG titer and mortality in burn patients.
METHODS
From 1988 to 2011, 877 burn intensive care patients were evaluated for age, sex, total burn surface area (TBSA), multi organ failure (MOF), burn depth, escharotomy, fasciotomy, antibiotic use, co-morbidities, CAG titer and intubation. 
RESULTS
From 870 admitted patients, 190 patients were not enrolled. Increasing age was correlated with a higher mortality. The ABSI score of the deceased was 4 points and the TBSA was 20% higher than the survivors. The correlation for age, intubation, TBSA, inhalation injury, MOF, CAG titer, antibiotic use and escharotomy was significant. An increasing mortality was noted with antibiotic use and a CAG titer of 1:8 and higher. CAG titer of 1:8 and higher had a sensitivity of 51.1% and specificity of 86.3% for mortality. Multivariate analysis confirmed high influence of older age, MOF, comorbidities, antibiotic use and CAG titer of 1:8 and higher on mortality. There was a significant correlation for sex, younger age and CAG titer.
CONCLUSION
CAG titers of 1:8 and higher might warrant beginning of antimycotic treatment in elderly patients with high TBSA to avoid increase in mortality.
Full-Text [PDF 310 kb]   (2585 Downloads)    
Type of Study: Original Article | Subject: Special
ePublished: 2019/03/13

References
1. Saaiq M, Ashraf B. Epidemiology and outcome of self-inflicted burns at pakistan institute of medical sciences, islamabad. World J Plast Surg 2014;3:107-14.
2. Saaiq M, Ahmad S, Zaib MS. Burn wound infections and antibiotic susceptibility patterns at pakistan institute of medical sciences, islamabad, pakistan. World J Plast Surg 2015;4:9-15.
3. Moon P, Jithendran N. Invasive Fungal Infection with Absidia Corymbifera in Immunocompetent Patient with Electrical Scalp Burn. World J Plast Surg 2018;7:249-52.
4. Moreira-Oliveira MS, Mikami Y, Miyaji M, Imai T, Schreiber AZ, Moretti ML. Diagnosis of candidemia by polymerase chain reaction and blood culture: prospective study in a high-risk population and identification of variables associated with development of candidemia. Eur J Clin Microbiol Infect Dis 2005;24:721-6. doi: 10.1007/s10096-005-0041-7. [DOI:10.1007/s10096-005-0041-7]
5. Maaroufi Y, De Bruyne JM, Duchateau V, Georgala A, Crokaert F. Early detection and identification of commonly encountered Candida species from simulated blood cultures by using a real-time PCR-based assay. J Mol Diagn 2004;6:108-14. doi: 10.1016/S1525-1578(10)60498-9. [DOI:10.1016/S1525-1578(10)60498-9]
6. Maaroufi Y, Ahariz N, Husson M, Crokaert F. Comparison of different methods of isolation of DNA of commonly encountered Candida species and its quantitation by using a real-time PCR-based assay. J Clin Microbiol 2004;42:3159-63. doi: 10.1128/JCM.42.7.3159-3163.2004. [DOI:10.1128/JCM.42.7.3159-3163.2004]
7. Sonmez A, Eksi F, Pehlivan M, Haydaroglu Sahin H. Investigating the presence of fungal agents in febrile neutropenic patients using different microbiological, serological, and molecular methods. Bosn J Basic Med Sci 2015;15:40-7. doi: 10.17305/bjbms.2015.409. [DOI:10.17305/bjbms.2015.409]
8. Trautwein-Weidner K, Gladiator A, Kirchner FR, Becattini S, Rulicke T, Sallusto F, LeibundGut-Landmann S. Antigen-Specific Th17 Cells Are Primed by Distinct and Complementary Dendritic Cell Subsets in Oropharyngeal Candidiasis. PLoS Pathog 2015;11:e1005164. doi: 10.1371/journal.ppat.1005164. [DOI:10.1371/journal.ppat.1005164]
9. Ballard J, Edelman L, Saffle J, Sheridan R, Kagan R, Bracco D, Cancio L, Cairns B, Baker R, Fillari P, Wibbenmeyer L, Voight D, Palmieri T, Greenhalgh D, Kemalyan N, Caruso D, Multicenter Trials Group ABA. Positive fungal cultures in burn patients: a multicenter review. J Burn Care Res 2008;29:213-21. doi: 10.1097/BCR.0b013e31815f6ecb. [DOI:10.1097/BCR.0b013e31815f6ecb]
10. Still JM, Jr., Belcher K, Law EJ. Management of candida septicaemia in a regional burn unit. Burns 1995;21:594-6. doi: 10.1016/0305-4179(95)00069-n . [DOI:10.1016/0305-4179(95)00069-N]
11. Jachec S, Perbix W, Lefering R, Diaz C, Spilker G, Weinand C. Candida-Antigen-Titer (CAG-Titer) for Detection and Early Treatment of Impending Candidemia. J Med Health Sci 2015;4:1-6.
12. Costa-de-Oliveira S, Pina-Vaz C, Mendonca D, Goncalves Rodrigues A. A first Portuguese epidemiological survey of fungaemia in a university hospital. Eur J Clin Microbiol Infect Dis 2008;27:365-74. doi: 10.1007/s10096-007-0448-4. [DOI:10.1007/s10096-007-0448-4]
13. Caetano M, Ramos S, Abreu J. Fungal infections at a Coimbra burns unit: 2003–2007. Abstract book [CD-ROM]. Presented at: 18th ECCMID. Abstract number R2459.
14. Pedrosa AF, Rodrigues AG. Candidemia in burn patients: figures and facts. J Trauma 2011;70:498-506. doi: 10.1097/TA.0b013e3181f2d4fb. [DOI:10.1097/TA.0b013e3181f2d4fb]
15. Cheng MF, Yang YL, Yao TJ, Lin CY, Liu JS, Tang RB, Yu KW, Fan YH, Hsieh KS, Ho M, Lo HJ. Risk factors for fatal candidemia caused by Candida albicans and non-albicans Candida species. BMC Infect Dis 2005;5:22. doi: 10.1186/1471-2334-5-22. [DOI:10.1186/1471-2334-5-22]
16. Belgian Outcome in Burn Injury Study G. Development and validation of a model for prediction of mortality in patients with acute burn injury. Br J Surg 2009;96:111-7. doi: 10.1002/bjs.6329. [DOI:10.1002/bjs.6329]
17. Tobiasen J, Hiebert JM, Edlich RF. The abbreviated burn severity index. Ann Emerg Med 1982;11:260-2. doi: 10.1016/s0196-0644(82)80096-6 . [DOI:10.1016/S0196-0644(82)80096-6]
18. Pittet D, Monod M, Suter PM, Frenk E, Auckenthaler R. Candida colonization and subsequent infections in critically ill surgical patients. Ann Surg 1994;220:751-8. doi: 10.1097/00000658-199412000-00008 . [DOI:10.1097/00000658-199412000-00008]
19. Eggimann P, Pittet D. Candida colonization index in the management of critically ill patients. In: Vincent JL, ed. Intensive Care Medicine. Annual Update 2006. New York: Springer New York; 2006; pp. 604-2.

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 CC BY-NC 4.0 | World Journal of Plastic Surgery

Designed & Developed by : Yektaweb