title: Positive peritoneal fluid fungal cultures in postoperative peritonitis after bariatric surgery.
abstract: Postoperative peritonitis (POP) is a common surgical complication after bariatric surgery (BS). We assessed the importance of positive fungal cultures in these cases of POP admitted to the intensive care unit. Clinical features and outcome were compared in 25 (41%) Candida-positive patients (6 (22%) fluconazole-resistant Candida glabrata) and 36 patients without Candida infection. Candida infections were more commonly isolated in late-onset peritonitis and were often associated with multidrug-resistant bacteria. Risk factors for intensive care unit mortality (19.6%) were diabetes and superobesity. Candida infections, including fluconazole-resistant strains, are common in POP after BS. These data encourage the empirical use of a broad-spectrum antifungal agent.
authors.affiliation: Département d'Anesthésie Réanimation, Université Paris Diderot Sorbonne Cite, APHP, CHU Bichat-Claude Bernard, France.
authors.forename: N
authors.initials: N
authors.lastname: Zappella
authors.affiliation: Département d'Anesthésie Réanimation, Université Paris Diderot Sorbonne Cite, APHP, CHU Bichat-Claude Bernard, France; Unité de Réanimation, Centre Hospitalier Sud-Francilien, Corbeil-Essonnes, France.
authors.forename: M
authors.initials: M
authors.lastname: Desmard
authors.affiliation: Laboratoire de Mycologie, Université Paris Diderot Sorbonne Cite, APHP, CHU Bichat-Claude Bernard, France.
authors.forename: C
authors.initials: C
authors.lastname: Chochillon
authors.affiliation: Service de Chirurgie Générale, Université Paris Diderot Sorbonne Cite, APHP, CHU Bichat-Claude Bernard, Paris, France.
authors.forename: L
authors.initials: L
authors.lastname: Ribeiro-Parenti
authors.affiliation: Laboratoire de Mycologie, Université Paris Diderot Sorbonne Cite, APHP, CHU Bichat-Claude Bernard, France.
authors.forename: S
authors.initials: S
authors.lastname: Houze
authors.affiliation: Service de Chirurgie Générale, Université Paris Diderot Sorbonne Cite, APHP, CHU Bichat-Claude Bernard, Paris, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Marmuse
authors.affiliation: Département d'Anesthésie Réanimation, Université Paris Diderot Sorbonne Cite, APHP, CHU Bichat-Claude Bernard, France. Electronic address: philippe.montravers@bch.aphp.fr.
authors.forename: P
authors.initials: P
authors.lastname: Montravers
mesh_terms: D000328:Adult; D001202:Ascitic Fluid / Q000382:microbiology*; D001419:Bacteria / Q000187:drug effects / Q000302:isolation & purification; D050110:Bariatric Surgery; D002175:Candida / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification*; D002177:Candidiasis / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality / Q000473:pathology; D060085:Coinfection / Q000453:epidemiology / Q000382:microbiology / Q000473:pathology; D025141:Drug Resistance, Fungal; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D015725:Fluconazole / Q000494:pharmacology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality / Q000473:pathology; D011183:Postoperative Complications / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality / Q000473:pathology; D011446:Prospective Studies; D012307:Risk Factors; D016019:Survival Analysis
chemical_list: D015725:Fluconazole
keywords: Antifungal therapy; bariatric surgery; fungal peritonitis; morbid obesity; postoperative peritonitis