Incidence of non-candidal fungal infections in severe burn injury: An Australian perspective

IntroductionInfection remains the primary cause of morbidity and mortality in the burns patient population. While candidal infection in burns patients is well described, there is dearth of information regarding non-candidal fungal infections in this setting.MethodAll adult burns patients who developed non-candidal fungal infections over a period of 10 years (between January 2001 and June 2011) were included. Retrospective data analyzed included patient demographics, organisms cultured, antibiotic susceptibility patterns, treatment, length of stay and overall mortality.ResultsThe incidence of non-candidal fungal infections at our centre over the time period studied was 0.04%. A total of 12 patients had a fungus other than Candida isolated. Of these 12 patients, seven were thought to have clinically significant fungal infections and were treated with targeted anti-fungal therapy. Between them, seven species of fungus were isolated: Aspergillus fumigatus (n = 7), Scedosporium prolificans (n = 2), Fusarium solani (n = 2), Mucor spp. (n = 2), Absydia corymbifera (n = 1), Penicillium (n = 1) and Alternaria spp. (n = 1). Of those definitively treated, two died, although fungal infection was not believed to be a contributing factor to these deaths.ConclusionWe demonstrate a low incidence and attributable mortality of non-candidal fungal infections in the setting of early antifungal therapy and extensive surgical debridement at our state-wide Burns Service.