Predictive factors of mortality due to polymicrobial peritonitis with Candida isolation in peritoneal fluid in critically ill patients.
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.
Dupont
Hervé
H
Department of Anesthesiology and Surgical Intensive Care Unit, University Hospital Bichat-Claude Bernard, Paris, France. herve.dupont@bch.ap-hop-paris.fr
Paugam-Burtz
Catherine
C
Muller-Serieys
Claudette
C
Fierobe
Lisiane
L
Chosidow
Denis
D
Marmuse
Jean-Pierre
JP
Mantz
Jean
J
Desmonts
Jean-Marie
JM
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