Post-cardiac surgery fungal mediastinitis: clinical features, pathogens and outcome
dc.rights.license | open | en_US |
hal.structure.identifier | Institut Pierre Louis d'Epidémiologie et de Santé Publique [iPLESP] | |
hal.structure.identifier | Groupe de Recherche Clinique en Anesthésie Réanimation médecine PEriopératoire [GRC 29 - ARPE] | |
dc.contributor.author | HARIRI, Geoffroy | |
hal.structure.identifier | Hôpitaux Universitaires de Genève [HUG] | |
dc.contributor.author | GENOUD, Mathieu | |
hal.structure.identifier | Centre Hospitalier Universitaire de Nice [CHU Nice] | |
hal.structure.identifier | Groupe de Recherche Clinique en Anesthésie Réanimation médecine PEriopératoire [GRC 29 - ARPE] | |
dc.contributor.author | BRUCKERT, Vincent | |
hal.structure.identifier | CHU Henri Mondor [Créteil] | |
dc.contributor.author | CHOSIDOW, Samuel | |
hal.structure.identifier | Hôpital Européen Georges Pompidou [APHP] [HEGP] | |
dc.contributor.author | GUÉROT, Emmanuel | |
hal.structure.identifier | Défaillance Cardiovasculaire Aiguë et Chronique [DCAC] | |
dc.contributor.author | KIMMOUN, Antoine | |
hal.structure.identifier | Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou] | |
hal.structure.identifier | Nutrition, Métabolismes et Cancer [NuMeCan] | |
dc.contributor.author | NESSELER, Nicolas | |
hal.structure.identifier | CHU Rouen | |
hal.structure.identifier | Endothélium, valvulopathies et insuffisance cardiaque [EnVI] | |
dc.contributor.author | BESNIER, Emmanuel | |
hal.structure.identifier | Centre cardiologique du Nord [CCN] | |
dc.contributor.author | DAVIAUD, Fabrice | |
hal.structure.identifier | CHU Marseille | |
dc.contributor.author | LAGIER, David | |
hal.structure.identifier | CHU Pessac | |
hal.structure.identifier | Biologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases | |
dc.contributor.author | IMBAULT, Julien | |
hal.structure.identifier | Hôpital Erasme [Bruxelles] [ULB] | |
dc.contributor.author | GRIMALDI, David | |
hal.structure.identifier | CHU Pitié-Salpêtrière [AP-HP] | |
hal.structure.identifier | Groupe de Recherche Clinique en Anesthésie Réanimation médecine PEriopératoire [GRC 29 - ARPE] | |
dc.contributor.author | BOUGLÉ, Adrien | |
hal.structure.identifier | IMRB - GEIC2O/"Genetic and Environmental Interactions in COPD, Cystic fibrosis and Other (rare) respiratory diseases" [Créteil] [U955 Inserm - UPEC] | |
hal.structure.identifier | CHU Henri Mondor [Créteil] | |
dc.contributor.author | MONGARDON, Nicolas | |
dc.date.accessioned | 2024-01-16T14:20:56Z | |
dc.date.available | 2024-01-16T14:20:56Z | |
dc.date.issued | 2023 | |
dc.identifier.issn | 1364-8535 | en_US |
dc.identifier.uri | https://oskar-bordeaux.fr/handle/20.500.12278/187274 | |
dc.description.abstractEn | Objectives: The occurrence of mediastinitis after cardiac surgery remains a rare and severe complication associated with poor outcomes. Whereas bacterial mediastinitis have been largely described, little is known about their fungal etiologies. We report incidence, characteristics and outcome of post-cardiac surgery fungal mediastinitis. Methods: Multicenter retrospective study among 10 intensive care units (ICU) in France and Belgium of proven cases of fungal mediastinitis after cardiac surgery (2009-2019). Results: Among 73,688 cardiac surgery procedures, 40 patients developed fungal mediastinitis. Five were supported with left ventricular assist device and five with veno-arterial extracorporeal membrane oxygenation before initial surgery. Twelve patients received prior heart transplantation. Interval between initial surgery and mediastinitis was 38 [17-61] days. Only half of the patients showed local signs of infection. Septic shock was uncommon at diagnosis (12.5%). Forty-three fungal strains were identified: Candida spp. (34 patients), Trichosporon spp. (5 patients) and Aspergillus spp. (4 patients). Hospital mortality was 58%. Survivors were younger (59 [43-65] vs. 65 [61-73] yo; p = 0.013), had lower body mass index (24 [20-26] vs. 30 [24-32] kg/m(2); p = 0.028) and lower Simplified Acute Physiology Score II score at ICU admission (37 [28-40] vs. 54 [34-61]; p = 0.012). Conclusion: Fungal mediastinitis is a very rare complication after cardiac surgery, associated with a high mortality rate. This entity should be suspected in patients with a smoldering infectious postoperative course, especially those supported with short-or long-term invasive cardiac support devices, or following heart transplantation. | |
dc.language.iso | EN | en_US |
dc.rights.uri | http://creativecommons.org/licenses/by/ | |
dc.subject.en | Cardiac surgery | |
dc.subject.en | Mediastinitis | |
dc.subject.en | Nosocomial infection | |
dc.subject.en | Healthcare-associated infection | |
dc.subject.en | Fungus | |
dc.subject.en | Candida | |
dc.subject.en | Aspergillus | |
dc.subject.en | Trichosporon | |
dc.title.en | Post-cardiac surgery fungal mediastinitis: clinical features, pathogens and outcome | |
dc.type | Article de revue | en_US |
dc.identifier.doi | 10.1186/s13054-022-04277-6 | en_US |
dc.subject.hal | Sciences du Vivant [q-bio] | en_US |
bordeaux.journal | Critical Care | en_US |
bordeaux.page | 6 | en_US |
bordeaux.volume | 27 | en_US |
bordeaux.hal.laboratories | Biologie des maladies cardiovasculaires (BMC) - UMR 1034 | en_US |
bordeaux.issue | 1 | en_US |
bordeaux.institution | Université de Bordeaux | en_US |
bordeaux.institution | INSERM | en_US |
bordeaux.peerReviewed | oui | en_US |
bordeaux.inpress | non | en_US |
bordeaux.import.source | hal | |
hal.identifier | hal-03967931 | |
hal.version | 1 | |
hal.popular | non | en_US |
hal.audience | Internationale | en_US |
hal.export | false | |
workflow.import.source | hal | |
dc.rights.cc | Pas de Licence CC | en_US |
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