title: Predictive factors of mortality due to polymicrobial peritonitis with Candida isolation in peritoneal fluid in critically ill patients.
abstract: BACKGROUND
  Candida peritonitis (CP) is generally considered to be a severe disease, but its impact on outcome in critically ill patients remains unknown.
  
  
  OBJECTIVE
  The predictive factors of mortality due to CP can be determined by study of a population of patients with CP.
  
  
  METHODS
  A retrospective review of a prospective surgical intensive care unit (ICU) database of patients (January 1, 1994, through December 31, 2000).
  
  
  METHODS
  University hospital in Paris, France.
  
  
  METHODS
  Eighty-three patients with generalized CP.
  
  
  METHODS
  Demographic and microbiologic data and outcome were collected, and nonsurvivors were compared with survivors.
  
  
  RESULTS
  Overall ICU mortality due to CP was 43 (52%) of 83 patients. In a stepwise multivariate logistic regression, the following 4 variables were independently associated with mortality: APACHE II (Acute Physiology and Chronic Health Evaluation II) score on admission of at least 17 (odds ratio [OR], 28.4; 95% confidence interval [CI], 5.7-142.5; P<.001), respiratory failure on admission (OR, 10.6; 95% CI, 2.2-51.2; P =.003), upper gastrointestinal tract site of peritonitis (OR, 7.7; 95% CI, 1.7-34.7; P =.007), and results of direct examination of peritoneal fluid that were positive for Candida (OR, 4.7; 95% CI, 1.2-19.7; P =.002).
  
  
  CONCLUSIONS
  These results confirm the severity of CP in ICU patients and emphasize the prognostic value of direct examination of peritoneal fluid for Candida in this context.
authors.affiliation: Department of Anesthesiology and Surgical Intensive Care Unit, University Hospital Bichat-Claude Bernard, Paris, France. herve.dupont@bch.ap-hop-paris.fr
authors.forename: Hervé
authors.initials: H
authors.lastname: Dupont
authors.forename: Catherine
authors.initials: C
authors.lastname: Paugam-Burtz
authors.forename: Claudette
authors.initials: C
authors.lastname: Muller-Serieys
authors.forename: Lisiane
authors.initials: L
authors.lastname: Fierobe
authors.forename: Denis
authors.initials: D
authors.lastname: Chosidow
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Marmuse
authors.forename: Jean
authors.initials: J
authors.lastname: Mantz
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Desmonts
mesh_terms: D018806:APACHE; D000368:Aged; D001202:Ascitic Fluid / Q000382:microbiology*; D002176:Candida albicans / Q000302:isolation & purification; D041221:Candida glabrata / Q000302:isolation & purification; D016638:Critical Illness; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010538:Peritonitis / Q000382:microbiology / Q000401:mortality*; D011379:Prognosis; D012189:Retrospective Studies