侵袭性真菌感染增加烧伤后死亡风险
Allison B Frederick1, Savannah H Skidmore1, Aaron P Lesher2
1Department of Surgery, Medical University of South Carolina, Charleston, SC, United States.
概括
侵袭性真菌感染 (IFI) 在烧伤患者中显著增加死亡风险,几乎增加了十倍. 即使是轻微的烧伤 (<10%TBSA) 死亡率也超过20%,这凸显了在烧伤护理中对抗真菌策略的关键需求.
科学领域:
- 医学研究 医学研究
- 传染性疾病 传染性疾病
- 烧伤护理 烧伤护理
背景情况:
- 侵入性真菌感染 (IFI) 对住院患者构成致命威胁,特别是那些因免疫受损而受烧伤的患者.
- 在烧伤患者中,非Candida真菌感染的发生率正在上升.
研究的目的:
- 评估烧伤患者中与IFI相关的死亡率.
- 分析燃烧严重程度 (%TBSA) 对IFI相关死亡率的影响.
主要方法:
- 利用来自美国烧伤中心 (2002-2024) 的大型多机构电子健康记录数据集.
- 包括被诊断患有真菌菌菌的烧伤患者,并接受全身抗真菌药物治疗 (IFI队列).
- 倾向匹配的IFI队列与没有菌根或抗真菌治疗的烧伤患者的对照队列,基于性别,年龄和%TBSA.
主要成果:
- 燃烧患者和IFI的一年死亡率为18.5%,而对照组为1.9% (风险比:9.8).
- 死亡风险随着烧伤严重程度的逐步增加:TBSA<10%的21.6%,TBSA10%-49%的29.0%,TBSA>50%的33.1%.
- 阿斯伯吉勒斯菌,入侵性坎迪达菌和未指定的真菌菌是最常见和最致命的真菌感染.
结论:
- 真菌感染与所有烧伤患者的死亡率增加近10倍有关.
- 烧伤严重程度显著影响IFI相关的死亡率,即使是轻微的烧伤 (<10%TBSA) 也会带来20%以上的死亡风险.
- 有效的抗真菌治疗和预防策略对于改善FI风险的烧伤患者的治疗结果至关重要.
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