Intra-Abdominal Candidiasis

Abstract

Intra-abdominal candidiasis (IAC) is the second most common form of invasive candidiasis after candidaemia. IAC is a broad term and can be classified on the basis of anatomical site (Candida peritonitis, pancreatic candidiasis, biliary tract candidiasis, gastrointestinal candidiasis, and hepatosplenic candidiasis) as well as clinical setting (community acquired versus nosocomial). The risk factors linked with IAC are candida colonisation, anastomotic leak, multiple instrumentation, long-term broad spectrum antibiotic use, total parenteral nutrition, and immunocompromised state. Clinically, IAC is not different from intraabdominal bacterial infection. Patients generally present with signs and symptoms of intra-abdominal sepsis after not responding to antibiotic therapy and with a background history of multiple surgical interventions or history of delayed source control. Radiological investigations, like ultrasonography and computed tomography scan, not only aid in diagnosis but also assist in differentiating medical from surgical cases. Microbiological diagnosis requires isolation of candida from an intra-abdominal specimen. Differentiation between colonisation and infection is difficult. Generally, progressive and persistent colonisation is associated with high risk of infection. Blood cultures have poor sensitivity for IAC. Non-culture based techniques used for diagnosis are mannan/anti-mannan assay, beta-D glucan assay, and validated polymerase chain reaction. Four types of antifungal strategies described in the literature are prophylaxis (risk factor driven), pre-emptive (colonisation or biomarker driven), empirical (fever driven), and targeted therapy (microbiology driven). Over recent years, global epidemiology has shown a shift from Candida albicans to non-albicans. Local epidemiology plays an important role in selection of the appropriate empirical therapy. The purpose of this review is to discuss different types of IAC based on their classification, risk factors, and management.

The fungicidal effectiveness of 2-Chloro-3-hydrazinylquinoxaline, a newly developed quinoxaline derivative, against Candida species

“…stand as a prominent contributor to both morbidity and mortality [1]. These infections manifest in diverse clinical presentations, encompassing intra-abdominal candidiasis, bloodstream infections, superficial candidiasis, and deep-seated infections [2]. Over recent decades, the incidence of Candida spp.…”

Holotoxin A1 from Apostichopus japonicus inhibited oropharyngeal and intra‐abdominal candidiasis by inducing oxidative damage in Candida albicans

“…Intra-abdominal candidiasis, as the most common deep-seated candidiasis, results from introduction of Candida into the normally sterile peritoneal cavity by direct inoculation, such as infected peritoneal dialysis catheters or leakage of content from the perforated gastrointestinal tract (Cheng et al, 2013). The prevalence of intraabdominal candidiasis was about 4.7 per 1000 (Azim et al, 2017). The intra-abdominal candidiasis models are widely used to investigate the virulence mechanisms of C. albicans (Ashizawa et al, 2019) and to evaluate the therapeutic effects of antifungal agents for systematic fungal infection (Lee et al, 2020(Lee et al, , 2021.…”

The differential dendritic cell properties in response to candida albicans and non-albican candida β-glucan

“…Comparing to the past, Candida non-albicans spp. have tended to be more dominant than C. albicans which has been known as a common pathogen previously (Azim et al, 2017;Lamoth et al, 2018). As shown in Figure 2.1, the remarkable increase of NACs infections was higher when compared to C. albicans with the percentage ranging up to 80% in some countries, for example in USA, Brazil, Peru, and India (Lamoth et al, 2018).…”

“…These fungi could attack at superficial locations with mild symptoms to systemic invasion with severe tissue damages, even life-threatening situations. Some Candida infections have been reported in patients including oral candidiasis, vaginitis, candidemia, candidiasis peritonitis, biliary candidiasis, hepatosplenic candidiasis, pancreatic candidiasis, gastrointestinal candidiasis, renal candidiasis, endocarditis, and meningoencephalitis consequences of candidemia (Gupta et al, 2015;Azim et al, 2017;Miranda-Cadena et al, 2018;Walsh et al, 2019).…”

“…Another study of invasive candidiasis in Turkey hospitalized children also found that the proportion of NACs infection accounted for 70% of total candidiasis (Öncü et al, 2019). Azim et al, 2017;Lamoth et al, 2018;Öncü et al, 2019). The infected frequency of each above species among candidiasis alters depending on underlying diseases, geometric areas throughout the world, research designs (Pfaller et al, 2008;Lamoth et al, 2018).…”