Combat trauma-associated invasive fungal wound infections: epidemiology and clinical classification

Amy Weintrob(Uniformed Services University of the Health Sciences), Allison B. Weisbrod(Walter Reed National Military Medical Center), James R. Dunne(Uniformed Services University of the Health Sciences), Carlos J. Rodríguez(Walter Reed National Military Medical Center), Daniel J. Malone(Walter Reed National Military Medical Center), Bradley A. Lloyd(Landstuhl Regional Medical Center), Tyler Warkentien(Walter Reed National Military Medical Center), J. Mitchell Wells(Walter Reed National Military Medical Center), Clinton K. Murray(Brooke Army Medical Center), William P. Bradley(Uniformed Services University of the Health Sciences), Faraz Shaikh(Uniformed Services University of the Health Sciences), Jigar Shah(Uniformed Services University of the Health Sciences), Deepak Aggarwal(Uniformed Services University of the Health Sciences), M Leigh Carson(Uniformed Services University of the Health Sciences), David R. Tribble(Uniformed Services University of the Health Sciences)
Epidemiology and Infection
March 18, 2014
10.1017/s095026881400051x
Cited by 54Open Access
Full Text

Abstract

The emergence of invasive fungal wound infections (IFIs) in combat casualties led to development of a combat trauma-specific IFI case definition and classification. Prospective data were collected from 1133 US military personnel injured in Afghanistan (June 2009-August 2011). The IFI rates ranged from 0·2% to 11·7% among ward and intensive care unit admissions, respectively (6·8% overall). Seventy-seven IFI cases were classified as proven/probable (n = 54) and possible/unclassifiable (n = 23) and compared in a case-case analysis. There was no difference in clinical characteristics between the proven/probable and possible/unclassifiable cases. Possible IFI cases had shorter time to diagnosis (P = 0·02) and initiation of antifungal therapy (P = 0·05) and fewer operative visits (P = 0·002) compared to proven/probable cases, but clinical outcomes were similar between the groups. Although the trauma-related IFI classification scheme did not provide prognostic information, it is an effective tool for clinical and epidemiological surveillance and research.

Related Papers

No related papers found

Powered by citation graph analysis