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Post-cardiac surgery fungal mediastinitis: clinical features, pathogens and outcome

dc.rights.licenseopenen_US
hal.structure.identifierInstitut Pierre Louis d'Epidémiologie et de Santé Publique [iPLESP]
hal.structure.identifierGroupe de Recherche Clinique en Anesthésie Réanimation médecine PEriopératoire [GRC 29 - ARPE]
dc.contributor.authorHARIRI, Geoffroy
hal.structure.identifierHôpitaux Universitaires de Genève [HUG]
dc.contributor.authorGENOUD, Mathieu
hal.structure.identifierCentre Hospitalier Universitaire de Nice [CHU Nice]
hal.structure.identifierGroupe de Recherche Clinique en Anesthésie Réanimation médecine PEriopératoire [GRC 29 - ARPE]
dc.contributor.authorBRUCKERT, Vincent
hal.structure.identifierCHU Henri Mondor [Créteil]
dc.contributor.authorCHOSIDOW, Samuel
hal.structure.identifierHôpital Européen Georges Pompidou [APHP] [HEGP]
dc.contributor.authorGUÉROT, Emmanuel
hal.structure.identifierDéfaillance Cardiovasculaire Aiguë et Chronique [DCAC]
dc.contributor.authorKIMMOUN, Antoine
hal.structure.identifierCentre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
hal.structure.identifierNutrition, Métabolismes et Cancer [NuMeCan]
dc.contributor.authorNESSELER, Nicolas
hal.structure.identifierCHU Rouen
hal.structure.identifierEndothélium, valvulopathies et insuffisance cardiaque [EnVI]
dc.contributor.authorBESNIER, Emmanuel
hal.structure.identifierCentre cardiologique du Nord [CCN]
dc.contributor.authorDAVIAUD, Fabrice
hal.structure.identifierCHU Marseille
dc.contributor.authorLAGIER, David
hal.structure.identifierCHU Pessac
hal.structure.identifierBiologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases
dc.contributor.authorIMBAULT, Julien
hal.structure.identifierHôpital Erasme [Bruxelles] [ULB]
dc.contributor.authorGRIMALDI, David
hal.structure.identifierCHU Pitié-Salpêtrière [AP-HP]
hal.structure.identifierGroupe de Recherche Clinique en Anesthésie Réanimation médecine PEriopératoire [GRC 29 - ARPE]
dc.contributor.authorBOUGLÉ, Adrien
hal.structure.identifierIMRB - GEIC2O/"Genetic and Environmental Interactions in COPD, Cystic fibrosis and Other (rare) respiratory diseases" [Créteil] [U955 Inserm - UPEC]
hal.structure.identifierCHU Henri Mondor [Créteil]
dc.contributor.authorMONGARDON, Nicolas
dc.date.accessioned2024-01-16T14:20:56Z
dc.date.available2024-01-16T14:20:56Z
dc.date.issued2023
dc.identifier.issn1364-8535en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/187274
dc.description.abstractEnObjectives: 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.isoENen_US
dc.rights.urihttp://creativecommons.org/licenses/by/
dc.subject.enCardiac surgery
dc.subject.enMediastinitis
dc.subject.enNosocomial infection
dc.subject.enHealthcare-associated infection
dc.subject.enFungus
dc.subject.enCandida
dc.subject.enAspergillus
dc.subject.enTrichosporon
dc.title.enPost-cardiac surgery fungal mediastinitis: clinical features, pathogens and outcome
dc.typeArticle de revueen_US
dc.identifier.doi10.1186/s13054-022-04277-6en_US
dc.subject.halSciences du Vivant [q-bio]en_US
bordeaux.journalCritical Careen_US
bordeaux.page6en_US
bordeaux.volume27en_US
bordeaux.hal.laboratoriesBiologie des maladies cardiovasculaires (BMC) - UMR 1034en_US
bordeaux.issue1en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
bordeaux.import.sourcehal
hal.identifierhal-03967931
hal.version1
hal.popularnonen_US
hal.audienceInternationaleen_US
hal.exportfalse
workflow.import.sourcehal
dc.rights.ccPas de Licence CCen_US
bordeaux.COinSctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Critical%20Care&rft.date=2023&rft.volume=27&rft.issue=1&rft.spage=6&rft.epage=6&rft.eissn=1364-8535&rft.issn=1364-8535&rft.au=HARIRI,%20Geoffroy&GENOUD,%20Mathieu&BRUCKERT,%20Vincent&CHOSIDOW,%20Samuel&GU%C3%89ROT,%20Emmanuel&rft.genre=article


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