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

A. C. Weintrob; A. B. Weisbrod; J. R. Dunne; C. J. Rodriguez; D. Malone; B. A. Lloyd; T. E. Warkentien; J. Wells; C. K. Murray; W. Bradley; F. Shaikh; J. Shah; D. Aggarwal; M. L. Carson; D. R. Tribble

doi:10.1017/S095026881400051X

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

A. C. Weintrob, A. B. Weisbrod, J. R. Dunne, C. J. Rodriguez, D. Malone, B. A. Lloyd, T. E. Warkentien, J. Wells, C. K. Murray, W. Bradley, F. Shaikh, J. Shah, D. Aggarwal, M. L. Carson, D. R. Tribble^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

43 Scopus citations

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.

Original language	English
Pages (from-to)	214-224
Number of pages	11
Journal	Epidemiology and Infection
Volume	143
Issue number	1
DOIs	https://doi.org/10.1017/S095026881400051X
State	Published - 16 Jan 2015
Externally published	Yes

Keywords

Epidemiology
fungi - infections due to
surveillance

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10.1017/S095026881400051X

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Weintrob, A. C., Weisbrod, A. B., Dunne, J. R., Rodriguez, C. J., Malone, D., Lloyd, B. A., Warkentien, T. E., Wells, J., Murray, C. K., Bradley, W., Shaikh, F., Shah, J., Aggarwal, D., Carson, M. L., & Tribble, D. R. (2015). Combat trauma-associated invasive fungal wound infections: Epidemiology and clinical classification. Epidemiology and Infection, 143(1), 214-224. https://doi.org/10.1017/S095026881400051X

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title = "Combat trauma-associated invasive fungal wound infections: Epidemiology and clinical classification",

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.",

keywords = "Epidemiology, fungi - infections due to, surveillance",

author = "Weintrob, {A. C.} and Weisbrod, {A. B.} and Dunne, {J. R.} and Rodriguez, {C. J.} and D. Malone and Lloyd, {B. A.} and Warkentien, {T. E.} and J. Wells and Murray, {C. K.} and W. Bradley and F. Shaikh and J. Shah and D. Aggarwal and Carson, {M. L.} and Tribble, {D. R.}",

note = "Publisher Copyright: {\textcopyright} The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. 2014.",

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doi = "10.1017/S095026881400051X",

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Weintrob, AC, Weisbrod, AB, Dunne, JR, Rodriguez, CJ, Malone, D, Lloyd, BA, Warkentien, TE, Wells, J , Murray, CK, Bradley, W, Shaikh, F, Shah, J, Aggarwal, D, Carson, ML & Tribble, DR 2015, 'Combat trauma-associated invasive fungal wound infections: Epidemiology and clinical classification', Epidemiology and Infection, vol. 143, no. 1, pp. 214-224. https://doi.org/10.1017/S095026881400051X

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T2 - Epidemiology and clinical classification

AU - Weintrob, A. C.

AU - Weisbrod, A. B.

AU - Dunne, J. R.

AU - Rodriguez, C. J.

AU - Malone, D.

AU - Lloyd, B. A.

AU - Warkentien, T. E.

AU - Wells, J.

AU - Murray, C. K.

AU - Bradley, W.

AU - Shaikh, F.

AU - Shah, J.

AU - Aggarwal, D.

AU - Carson, M. L.

AU - Tribble, D. R.

PY - 2015/1/16

Y1 - 2015/1/16

N2 - 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.

AB - 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.

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KW - fungi - infections due to

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SP - 214

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JO - Epidemiology and Infection

JF - Epidemiology and Infection

IS - 1

ER -

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

Abstract

Keywords

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