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Epidemiol Infect. 2015 Jan;143(1):214-24. doi: 10.1017/S095026881400051X. Epub 2014 Mar 18.

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

Author information

1
Walter Reed National Military Medical Center,Bethesda, MD,USA.
2
Department of Surgery,Uniformed Services University of the Health Sciences,Bethesda, MD,USA.
3
Landstuhl Regional Medical Center,Landstuhl,Germany.
4
San Antonio Military Medical Center,Fort Sam Houston, TX,USA.
5
Infectious Disease Clinical Research Program,Uniformed Services University of the Health Sciences,Bethesda, MD,USA.

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.

PMID:
24642013
PMCID:
PMC4946850
DOI:
10.1017/S095026881400051X
[Indexed for MEDLINE]
Free PMC Article
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