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Updated: Jun 17, 2026
An Ex vivo Assay to Study Candida albicans Hyphal Morphogenesis in the Gastrointestinal Tract
Published on: July 1, 2020
Multi-state evaluation of Candida infections in burn patients
Maryam Salimi1,2, Javad Javidnia2,3, Mahdi Abastabar2,3
1Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
Background:
Burn patients are at high risk of developing secondary invasive fungal infections due to their compromised skin barrier, extensive use of antibiotics, and immunosuppression.
Objectives:
We investigated demographic characteristics and clinical factors associated with Candida infections in intensive care unit (ICU) burn patients, and the in vitro antifungal susceptibility of species of isolates.
Methods:
A total of 353 burn patients admitted to three major ICUs of burn centers in Iran were evaluated between 2021 and 2023. Patients were considered as colonisation and candidemia. Demographic characteristics, burn-related factors, and clinical conditions were compared among the groups. Furthermore, we identified fungi at the species level and performed antifungal susceptibility testing according to CLSI guidelines.
Results:
Overall, 46.2% of patients were colonised with a Candida species, leading to candidemia in 15.3%. The most frequently isolated species from candidemia and burn wound colonisation were Candida parapsilosis (37.0%) and Candida albicans (31.9%), respectively. Risk factors linked to candidemia included larger total body surface area (TBSA) (>50%), older patients, indwelling catheters, diabetes, and an extended ICU stay. Mortality rate was higher among candidemia patients (82.5%) compared to colonised patients (7.3%). The resistance rate of the strains isolated from candidemia to fluconazole and voriconazole was 28% and 18.2%, respectively.
Conclusion:
We found that a higher percentage of TBSA burn injuries, longer hospital stays, and catheterization are important predictors of candidemia. The mortality rate was significantly higher in people infected with non-albicans Candida species. Prevention and treatment strategies for candidemia should be based on updated, regional epidemiological data.
Insights
Candida infections are common in burn patients, with risk factors including large burn size and catheter use. Candidemia significantly increases mortality, highlighting the need for updated prevention strategies based on regional data.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Burn Surgery
Background:
- Burn patients face high risks of invasive fungal infections due to compromised skin barriers, antibiotic use, and immunosuppression.
- Candida species are a significant cause of secondary infections in intensive care unit (ICU) settings for burn patients.
Purpose of the Study:
- To investigate demographic and clinical factors associated with Candida infections in ICU burn patients.
- To determine the in vitro antifungal susceptibility of isolated Candida species.
Main Methods:
- A study of 353 burn patients in Iranian ICUs from 2021-2023.
- Analysis of demographic data, burn factors, clinical conditions, and species identification of Candida isolates.
- Antifungal susceptibility testing performed according to CLSI guidelines.
Main Results:
- 46.2% of patients were colonized, and 15.3% developed candidemia.
- Candida parapsilosis and Candida albicans were the most common species.
- Risk factors for candidemia included large TBSA burns, older age, catheters, diabetes, and prolonged ICU stay. Mortality was 82.5% in candidemia patients.
Conclusions:
- Increased TBSA burn, prolonged hospital stays, and catheterization predict candidemia.
- Non-albicans Candida species infections were associated with higher mortality rates.
- Updated, regional epidemiological data are crucial for effective candidemia prevention and treatment strategies.
