title: Intra-abdominalCandidaspp infection in acute abdomen in a quality assurance (QA)-certified academic setting.
abstract: OBJECTIVE
  To evaluate the contribution of light microscopy to detectingCandidaspp infection in patients with complicated intra-abdominal infections (IAIs) admitted for acute abdomen to a quality assurance (QA)-certified surgical emergency ward.
  
  
  METHODS
  We conducted a retrospective study (2008-2012) of 809 abdominal intraoperative or biopsy tissue specimens obtained from patients admitted with acute abdomen and microbiological samples positive forCandidaspp. Demographic data, mortality, comorbidities, specimen type, microscopy results, special histological staining performed, antimicrobial therapy were collected and analysed. Any comments at the multidisciplinary team meeting was recorded in minutes of and approved.
  
  
  RESULTS
  Sixty-six patients with complicated IAIs due toCandidaspp were identified (39 male, 27 female, mean±SD age 75±20 years).Candida albicanswas isolated in 35 cases andCandida non-albicansspp in 31 cases.Candidaspp were isolated from blood in 50% of all selected microbiological specimens. Patients were stratified according toCandidaspp(albicansvsnon-albicans), underlying cancer disease and no previous antimicrobial administration, and a positive correlation withC. albicansisolation was found (p=0.009 and p=0.048, respectively). Out of 41 cases with microscopic evaluation, we identified yeast forms, pseudohyphae or both, indicative ofCandidaspp, in 23. Identification ofCandidaspp in histological specimens was higher inC. albicanscases than inC. non-albicanscases (73% vs 37.5%). Microscopy allowed prompt treatment of all patients.
  
  
  CONCLUSIONS
  Light microscopy still has great diagnostic significance, being a solid QA step. It provides rapid information and clues in patients who may harbour impaired defence mechanisms, concurrent chronic conditions and/or cancer.
authors.affiliation: Department of Sciences for Health Promotion and Mother & Child Care, Section of Anatomic Pathology, University of Palermo, Palermo, Italy.
authors.forename: Vito
authors.initials: V
authors.lastname: Rodolico
authors.affiliation: Department of Sciences for Health Promotion and Mother & Child Care, Section of Infectious Disease, University of Palermo, Palermo, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Di Carlo
authors.affiliation: Department of General Surgery and Emergency, University of Palermo, Palermo, Italy.
authors.forename: Gaspare
authors.initials: G
authors.lastname: Gulotta
authors.affiliation: Department of General Surgery and Emergency, University of Palermo, Palermo, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: D'Arpa
authors.affiliation: Department of General Surgery and Emergency, University of Palermo, Palermo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Salamone
authors.affiliation: Department of General Surgery and Emergency, University of Palermo, Palermo, Italy.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Cocorullo
authors.affiliation: Department of General Surgery and Emergency, University of Palermo, Palermo, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Agrusa
authors.affiliation: Department of Sciences for Health Promotion and Mother & Child Care, Section of Microbiology, University of Palermo, Palermo, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Giammanco
authors.affiliation: Department of Lab. Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada.|Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Consolato
authors.initials: C
authors.lastname: Sergi
mesh_terms: D000006:Abdomen, Acute / Q000382:microbiology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000627:therapeutic use; D002175:Candida / Q000302:isolation & purification; D002177:Candidiasis / Q000000981:diagnostic imaging* / Q000188:drug therapy; D054714:Echinocandins / Q000627:therapeutic use; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008853:Microscopy / Q000379:methods; D008875:Middle Aged; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D015725:Fluconazole
keywords: FUNGI; GASTROENTEROLOGY; INFECTIONS; INFECTIOUS INTESTINAL DISEASE