ArticleOpen forum infectious diseases2014
Resistance patterns and clinical significance of Candida colonization and infection in combat-related injured patients from iraq and afghanistan.
Article in Open forum infectious diseases, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 18 citations in OpenAlex.
- Microbiome dynamics in the congregate environment of U.S. Army Infantry training.Microbiology spectrum · 2026Article
- Rare multi-fungal sepsis: a case of triple-impact immunoparalysis.Folia microbiologica · 2024Article
- Multidrug-Resistant and Virulent Organisms Trauma Infections: Trauma Infectious Disease Outcomes Study Initiative.Military medicine · 2022Review
- Microbiology of combat-related extremity wounds: Trauma Infectious Disease Outcomes Study.Diagnostic microbiology and infectious disease · 2019Article
- Microbiology and risk factors associated with war-related wound infections in the Middle East.Epidemiology and infection · 2016Review
- Epidemiology and antimicrobial susceptibilities of wound isolates of obligate anaerobes from combat casualties.Diagnostic microbiology and infectious disease · 2016Article
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundPenetrating wounds with environmental contamination are associated with a range of infectious complications, including fungus. This is the first study to examine the epidemiology, resistance patterns, and outcomes of Candida infections and colonization in United States military patients injured in Iraq and Afghanistan.
methodsClinical information associated with initial unique and serial Candida isolates collected from patients (June 2009-October 2013) through the Trauma Infectious Disease Outcomes Study (TIDOS) was evaluated. Susceptibilities were performed using Sensititre YeastOne (YO-9) plates and interpreted by Clinical Laboratory and Standards Institute (CLSI) and adjusted-European Committee on Antimicrobial Susceptibility Testing (EUCAST) criteria.
resultsThe analysis included 127 patients with 131 unique Candida isolates, of which 102 were Candida albicans and 29 non-albicans Candida spp. Overall, 99% of patients were male with a median age of 23 and an injury severity score of 22. Injuries were primarily due to blasts (77%) and sustained among personnel serving in Afghanistan (89%). There was a median of 7 days from injury to Candida isolation, and 74 isolates were associated with infection. In the multivariate analysis, non-albicans Candida spp were associated with prior antifungal exposure, blood isolates, and wound isolates (P < .01). Nonsusceptibility by CLSI and EUCAST criteria was associated with non-albicans Candida spp (P < .05). Patients with Candida isolation had a 7.1% mortality rate, compared with 1.4% from the overall TIDOS population.
conclusionsCandida isolation from patients with penetrating war injuries may identify a population at higher risk for death. Prospective studies are needed to determine whether targeted antifungals and surgical management will affect this mortality rate.
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