The Survey of Fungal Wounds Infections in Burn Patients in Isfahan, Iran

Abstract

Background: Bacteria, fungi, and viruses have the ability to colonize in burned lesions. Due to the wide use of antibacterial drugs, this colonization is increasing.These drugs induce impairment of immune system in burn patients, destruction of blood vessels, and presence of fungal agents in environment and body normal flora, colonization of fungi tends to induction of infection. The most common fungi in burn patients are Candida spp., Aspergillus spp., and other molds such as Mucorals. Nowadays, antifungals drugs cause resistance increasing in non-albicans spp., uncommon molds, and yeasts. This study aimed to determine fungal infections in burn patients. Methods: From 111 hospitalized burn patients at Isfahan burn center, Iran, during February 2016 to April 2017, sampling was performed via pus swabs and skin scraping. Each sample divided into two parts; one for direct exam by 10% potassium hydroxide (KOH) and Giemsa staining. The second part cultured on Sabouraud dextrose agar with chloramphenicol (SC); then, incubated at 30°C for 24-48 hours, and after amplification, the polymerase chain reaction (PCR) product was purified and sent for DNA sequencing. Findings: Out of 111 patients, only one specimen was positive in direct exam, culture criteria, and DNA sequencing, in which, Neurospora sitophila isolated and identified. In the present study, the frequency of fungal species was 0.9%. Conclusion: Due to the consideration of antifungals at the early phase after burn injury, the low positive rate of fungal cultures is reasonable. This prophylaxis protocol is recommended to be considered in other burn centers.

Keywords

• Burns
• Wound infection
• Fungal infections