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Military Health System

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

Publication Status: Published

Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)

Sponsoring Office: Walter Reed National Military Medical Center

Congressionally Mandated: No

Funding Source: Agency, office or organization under authority of the Sec Def (not affiliated to Army, Navy, or Air Force)

Release Date/Publication: January 01, 2015

Principle Investigator Status: Government

Primary DoD Data Source: Other Clinical

Secondary DoD Data Source:

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.

Citation:

Weintrob AC, et. al., Combat trauma-associated invasive fungal wound infections: epidemiology and clinical classification. Epidemiol Infect. 2015 Jan;143(1):214-24.

Last Updated: February 21, 2019
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