Candida peritonitis due to peptic ulcer perforation: incidence rate, risk factors, prognosis and susceptibility to fluconazole and amphotericin B.
Sixty-two cases of peritonitis due to peptic ulcer perforation were diagnosed between January 2000 and December 2000. Of these 62 cases, 23 isolates of Candida in 23 cases (CP) were cultured from peritoneal fluid. Cultures of peritoneal fluid of 10 (BP) of the remaining 39 cases was positive for bacteria only. Cultures of peritoneal fluid of the remaining 29 cases was negative. Comparison of CP, BP and culture-negative cases did not reveal any significant risk factor. Of the 23 Candida isolates, the Candida species and 48-h MICs of fluconazole and amphotericin B (mean, range ug/ml) were C. albicans 18 (0.688, 0.125-1.0; 0.297, 0.031-0.5), C. glabrata 3 (0.542, 0.125-1.0; 0.25, 0.125-0.5), C. tropicalis 1 (0.25; 0.5), C. intermedia 1 (1.0; 0.125) respectively. Mortality rates of CP, BP and culture-negative peritonitis due to infection were 5/23(21.7%), 0/10 and 1/29(3.4%) respectively. Without effective antifungal therapy, the mortality rate of CP was not low.
Lee
Sai-Cheong
SC
Division of Infectious Diseases, Chang Gung Memorial Hospital, Keelung, Taiwan. Ruby800@adm.cgmh.com.tw
Fung
Chang-Phone
CP
Chen
Huang-Yang
HY
Li
Chiung-Tsung
CT
Jwo
Shyh-Chuan
SC
Hung
Yi-Ben
YB
See
Lai-Chu
LC
Liao
How-Chin
HC
Loke
Song-Seng
SS
Wang
Feng-Lin
FL
Lee
Jenq-Chang
JC
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000666:Amphotericin B / Q000008:administration & dosage*; D001202:Ascitic Fluid / Q000382:microbiology; D002175:Candida / Q000187:drug effects / Q000302:isolation & purification*; D015331:Cohort Studies; D005260:Female; D015725:Fluconazole / Q000008:administration & dosage*; D006801:Humans; D015994:Incidence; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010439:Peptic Ulcer Perforation / Q000150:complications* / Q000382:microbiology; D010538:Peritonitis / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology; D011336:Probability; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D018709:Statistics, Nonparametric; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology
D000666:Amphotericin B; D015725:Fluconazole