Prognostic factors for patients with culture-positive Candida infection undergoing abdominal surgery.
OBJECTIVE
Increased risk for fungal infections has been observed in high-risk surgical patients, but the prognostic factors and impact of antifungal agents in this patient population are uncertain, especially in patients undergoing abdominal operation. This study was performed to ascertain the prognostic factors for patients with culture-positive Candida spp. who have had abdominal surgery.


METHODS
From 2003 through 2006, all adult patients with positive candidal culture from abdominal specimens (peritoneal fluid obtained during laparotomy or drain effluent, abscess, or bile) at China Medical University Hospital, Taichung, Taiwan, were included in this retrospective study. Patients' demographic data, prognostic factors, and 30-day mortality rate related to fungal infection were analyzed by reviewing the medical charts.


RESULTS
Thirty nine patients were enrolled in the study. The overall mortality rate was 35.9%. Candida albicans was the most common isolate (82.5%). The major prognostic factors were number of surgical interventions, Gram-negative bacteremia, high Acute Physiology And Chronic Health Evaluation (APACHE) II score, corticosteroid use, and subsequent candidal infection (p < 0.05).


CONCLUSIONS
In patients with positive intra-abdominal candidal culture, greater numbers of surgical intervention, Gram-negative bacilli bacteremia, and high APACHE II score were the prognostic factors for mortality. Corticosteroid use might be a risk factor for subsequent candidal infection.
Hsu
Feng-Chien
FC
Department of Internal Medicine, Tungs' MetroHarbor Hospital, Taichung, Taiwan.
Lin
Po-Chang
PC
Chi
Chih-Yu
CY
Ho
Mao-Wang
MW
Ho
Cheng-Mao
CM
Wang
Jen-Hsien
JH
D018784:Abdominal Abscess / Q000382:microbiology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001202:Ascitic Fluid / Q000382:microbiology*; D001646:Bile / Q000382:microbiology*; D002175:Candida / Q000302:isolation & purification*; D002177:Candidiasis / Q000453:epidemiology* / Q000382:microbiology* / Q000401:mortality; D005260:Female; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013624:Taiwan