Scientific justification Invasive fungal diseases (IFDs) pose a substantial threat, especially in immunocompromised patients, necessitating urgent research focus and therapeutic advancements. The IFI-BURN study, involving a cohort of patients with severe burn injury (n=276), revealed a significant IFD incidence of 31.6% and underscored their critical impact on morbidity and mortality. While fungi are present everywhere, for moulds within the environment and for yeasts within our microbiota, why certain patients develop IFDs and others do not, remains poorly understood. The answer most likely resides in the impact of the burn injury on the immune response, loss of skin barrier and particular predisposing immune phenotype of patients. The immune system is composed of both cellular and humoral components, but the latter is far less studied in antifungal immunity although they exert multiple antimicrobial mechanisms.
Study Type
OBSERVATIONAL
Enrollment
327
Whole blood on EDTA sample 2 tubes (5mL) PAXgene sample 1 tube (2.5 mL) Rectal swab Skin swab (1 swab for 5 anatomically burned sites) At day 0, day 3, day 7, day 14, day 21
Invasive fungal disease (IFD) onset during hospitalisation time
Proven IFD according to EORTC/MSGERC criteria applicable for invasive candidiasis. Putative invasive mold infection is defined with ≥ 2 positive culture from skin biopsy/bronchoalveolar lavage or ≥ 2 positive blood specific qPCR (aspergilosis, mucorales, fusariosis) or a combination of both. Possible invasive mold infection is defined with only one positive mycological criterion.
Time frame: Up to 18 months
Overall survival
Time frame: At day 30
Overall survival
Time frame: At day 90
Hospital mortality
Time frame: Up to 18 months
Incidence of organ failure during hospitalisation
* Acute respiratory distress syndrome defined by the modified Berlin criteria, or * Acute kidney injury as defined by the KDIGO consensus, or * Septic shock and doses of catecholamines defined by SEPSIS-3
Time frame: Up to 18 months
Severity score at admission
SAPS 2 : Simplified Acute Physiology Score II The score can range from 0 to 163. Higher score indicates more severe illness and a higher risk of mortality. Lower score indicates less severe illness and a lower risk of mortality.
Time frame: At inclusion
Severity score at admission
ABSI Acute Bowel Ischemia Severity Index The score ranges from 0 to 10. A higher score indicates a more severe case and a higher risk of mortality.
Time frame: At inclusion
Severity score at admission
SOFA score : Sequential Organ Failure Assessment The score can range from 0 to 24, with higher scores indicating more severe organ failure and a worse prognosis.
Time frame: At inclusion
Number of days without renal replacement therapy
Time frame: At day 30
Number of days without mechanical ventilation
Time frame: At day 30
Length of stay in Intensive Care Unit
Time frame: Up to 18 months
Length of stay in hospital
Time frame: Up to 18 months
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