The pattern of fungal infections in critically ill surgical patients

E. E. Cornwell, H. Belzberg, T. V. Berne, W. R. Dougherty, I. R. Morales, Juan A. Asensio, D. Demetriades

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

There continues to be difficulty making the clinical distinction between fungal colonization and systemic infection in critically ill surgical patients. This distinction is important, given the potential risks of aggressive antifungal therapy. In order to evaluate the significance of fungal infections by various sites, we retrospectively reviewed the clinical courses of patients with cultures positive for fungi (Candida species or Torulopsis glabrata) in the SICU of LAC + USC Medical Center from January 1992-December 1993. There were 129 patients who were culture positive for Candida (110 patients) or Torulopsis glabrata (19 patients). There were 187 positive cultures. Fifty-five patients (43%) had systemic fungal infections (two or more sites, or fungemia). The proportion of patients with positive cultures from any given site going on to develop systemic infections was similar (wound, 49 per cent; urine, 54 per cent; sputum, 57 per cent; drain, 68 per cent; P = 0.61, NS). The mortality for SICU patients with systemic fungal infection was significantly increased (36.3% versus 10.5%, P <0.05) when compared with SICU patients in general. No significant increase in mortality was seen in patients with single site isolation (13.5% versus 10.5%, P = 0.52). This study suggests that although systemic fungal infection is associated with increased mortality in SICU patients, no single site of isolation is superior to others in predicting which patients are likely to develop systemic infection. Prospective studies with antifungal agents with reduced toxicity are justified in patients with single site isolation.

Original languageEnglish
Pages (from-to)847-850
Number of pages4
JournalAmerican Surgeon
Volume61
Issue number10
StatePublished - 1995
Externally publishedYes

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Mycoses
Critical Illness
Candida glabrata
Mortality
Infection
Fungemia
Antifungal Agents
Sputum
Candida
Fungi

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Cornwell, E. E., Belzberg, H., Berne, T. V., Dougherty, W. R., Morales, I. R., Asensio, J. A., & Demetriades, D. (1995). The pattern of fungal infections in critically ill surgical patients. American Surgeon, 61(10), 847-850.

The pattern of fungal infections in critically ill surgical patients. / Cornwell, E. E.; Belzberg, H.; Berne, T. V.; Dougherty, W. R.; Morales, I. R.; Asensio, Juan A.; Demetriades, D.

In: American Surgeon, Vol. 61, No. 10, 1995, p. 847-850.

Research output: Contribution to journalArticle

Cornwell, EE, Belzberg, H, Berne, TV, Dougherty, WR, Morales, IR, Asensio, JA & Demetriades, D 1995, 'The pattern of fungal infections in critically ill surgical patients', American Surgeon, vol. 61, no. 10, pp. 847-850.
Cornwell EE, Belzberg H, Berne TV, Dougherty WR, Morales IR, Asensio JA et al. The pattern of fungal infections in critically ill surgical patients. American Surgeon. 1995;61(10):847-850.
Cornwell, E. E. ; Belzberg, H. ; Berne, T. V. ; Dougherty, W. R. ; Morales, I. R. ; Asensio, Juan A. ; Demetriades, D. / The pattern of fungal infections in critically ill surgical patients. In: American Surgeon. 1995 ; Vol. 61, No. 10. pp. 847-850.
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