Yeast colonization in surgical patients with intra-abdominal perforations.
A prospective study was conducted to determine (i) the degree of yeast colonization in surgical patients with intra-abdominal perforations and (ii) whether the frequency of colonization is different in patients with a complicated postoperative course than in patients recovering uneventfully. A total of 1,496 specimens taken per- and post-operatively from the mouth, stomach, feces, urine, trachea, and abdomen of 109 surgical patients with intra-abdominal perforations were examined. Yeast was recovered from 98 (90%) of the patients and from 634 (42%) of the specimens. Approximately 70% of the specimens from the mouth and stomach, 47% of fecal specimens, and 31% of abdominal specimens were positive for yeast. A total of 42 patients had a complicated postoperative course. The majority of these patients were colonized with yeast at multiple body sites: yeast was recovered on one or more occasions from two or more body sites in 90% and from three or more body sites in 71%. Many of the patients with an uncomplicated postoperative course also were colonized: yeast was recovered from two or more body sites in 69% and from three or more body sites in 34%. The results of this study indicate that treatment recommendations based on yeast colonization will expose a large number of patients to unnecessary or even harmful antifungal treatment. This does not mean that yeast colonization is insignificant; however, more accurate criteria and methods based on prospective clinical studies are needed to detect patients at risk of developing severe Candida infection.
Sandven
P
P
Department of Bacteriology, National Institute of Public Health, Oslo, Norway. per.sandven@folkehelsa.no
Giercksky
K E
KE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000008:administration & dosage; D015169:Colony Count, Microbial; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007416:Intestinal Perforation / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D011183:Postoperative Complications / Q000188:drug therapy / Q000382:microbiology*; D011184:Postoperative Period; D011300:Preoperative Care; D011336:Probability; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate; D015003:Yeasts / Q000187:drug effects / Q000302:isolation & purification*
D000935:Antifungal Agents