Intra-abdominal<i>Candida</i>spp infection in acute abdomen in a quality assurance (QA)-certified academic setting

Rodolico, Vito; Carlo, Paola Di; Gulotta, Gaspare; D'Arpa, Francesco; Salamone, Giuseppe; Cocorullo, Gianfranco; Agrusa, Antonino; Giammanco, Anna; Sergi, Consolato

doi:10.1136/jclinpath-2016-203936

Cited by 8 publications

(11 citation statements)

References 43 publications

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“…In our case series, we underlined that a longer OA maintenance increases the risk of developing Candida infection. In [ 47 ], it is reported that Candida peritonitis is burdened by a high mortality rate (about 38%) and our case series attests to these values. Anyway, in our study, we must consider some biases.…”

Section: Discussionsupporting

confidence: 87%

“…As revealed by Cristaudo et al [ 36 ], currently, there are no published reviews of prognostic factors with regard to definitive fascial closure, mortality, and intra-abdominal complications of patients being managed with OA. Intra-abdominal infections are considered as emergencies, and a successful outcome depends on early diagnosis, an appropriate surgical treatment, and adequate antibiotic therapy [ 47 ]. The control of invasive Candida infections is related to a reduced mortality [ 23 , 38 , 47 ]; nevertheless, criteria for starting an empirical antifungal therapy are poor.…”

Section: Discussionmentioning

confidence: 99%

“…Intra-abdominal infections are considered as emergencies, and a successful outcome depends on early diagnosis, an appropriate surgical treatment, and adequate antibiotic therapy [ 47 ]. The control of invasive Candida infections is related to a reduced mortality [ 23 , 38 , 47 ]; nevertheless, criteria for starting an empirical antifungal therapy are poor. In many cases, unnecessary starting of antifungal therapy can cause resistance [ 39 , 40 ].…”

Section: Discussionmentioning

confidence: 99%

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Open Abdomen Management and Candida Infections: A Very Likely Link

Occhionorelli

Zese

Cultrera

et al. 2017

Gastroenterology Research and Practice

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Objective Laparostomy can be applied in trauma, abdominal sepsis, intra-abdominal hypertension, or compartment syndrome. Systemic infections, especially if complicated by Candida, are associated with a high risk of mortality. Methods This is a single-centre retrospective case series of 47 cases admitted to our Department, which required laparostomy procedure; we analyzed the type of surgery, temporary abdominal closure, duration of open abdomen, complications, SOFA score, mortality with Candida infections, and empirical or targeted antifungal therapy. Results We found that patients with Candida infection were related with a statistically significant difference (p < 0.05) with a complication after OA closure, total complications, time elapsed after OA application, time spent on the first surgical OA application, type of temporary abdominal closure that is used, and duration of the open abdomen. The use of empirical and targeted antifungal therapy is related to the duration of open abdomen too. Conclusions Management of the OA is often burdened by sepsis or septic shock, especially when complicated by Candida infection. Candida score is a validated tool to identify patients who can be treated empirically, but every situation must be considered on an individual basis.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Open Abdomen Management and Candida Infections: A Very Likely Link

Occhionorelli

Zese

Cultrera

et al. 2017

Gastroenterology Research and Practice

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“…Still, it is up to the "endocarditis multidisciplinary team" to understand, based on the history, local epidemiology, and clinical picture of the patient, what is the right antibiotic therapy and the timing, if necessary, of surgery [16][17]. Previously, we reported on the importance of multidisciplinary team (MDT) meetings in a Quality Assurance (QA)-certified academic setting [18].…”

Section: Introductionmentioning

confidence: 99%

Infective Endocarditis: Preliminary Results of a Cohort Study in the Southern Italian Population

Serra¹,

Colomba²,

Carlo³

et al. 2020

Cureus

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Background Infective endocarditis (IE) is an uncommon disease with an involved interplay of clinical and surgical team management. We aimed to define diagnosis parameters and delineate in-hospital management in patients with IE admitted in a tertiary hospital of Southern Italian. Materials and methods Fifty-six consecutive patients (42 males, 14 females; age range: 34-85 years) admitted for IE in the Infectious Diseases, Cardiac Surgery, and Cardiology units, between January 2011 and August 2017, were enrolled. Demographic data, mortality, comorbidities, specimen type, microscopy results, special histological staining performed, and antimicrobial therapy were collected and analyzed. Any comments at the multidisciplinary team meetings were recorded in minutes of and approved. Results We found 83.9% of patients with positive blood cultures. The four most common bacteria were methicillin-resistant Staphylococcus aureus (MRSA: 21.3%), methicillin-sensitive Staphylococcus aureus (MSSA: 17%), Streptococci (14.9%), and Enterococci (14.9%). Both in the univariate and multivariate analysis, we observed a significant positive correlation between surgery and complications. Particularly in the univariate analysis only, surgery was positively correlated to males and C-reactive protein (CPR) at baseline. Also, considering the most common bacteria, it resulted in a positive correlation between surgery and MRSA and Streptococci spp. and between complications and MSSA. Finally, the male gender was positively correlated to MSSA and heart complications, major arterial embolism, septic pulmonary emboli, splenic infarction, and cerebral embolism. Conclusions A blood culture test remains a critical factor for the diagnosis of IE and the antibiotic treatment 1 2 2,

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“…The prevalence of C. albicans and non- C. albicans species was comparable in this study, with non- C. albicans spp. being related mainly to critically ill surgical patients [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Candida lusitaniae – a case report of an intraperitoneal infection

Wawrysiuk

Rechberger

Futyma

et al. 2018

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Candida lusitaniae is a rare opportunistic yeast which is known for its resistance to amphotericin B (AmB). It is responsible for about 19.3% of all infections caused by non-Candida albicans species, and for about 1.7% of all cases of genitourinary candidiasis brought about by the entire spectrum of Candida species. Most commonly it occurs in patients with hematologic malignancies, especially when a patient is receiving chemotherapy. Candida lusitaniae infection usually presents with fungemia; however, only 7.3% of all patients will develop peritonitis.This case study describes an immunocompetent female patient with an intraperitoneal infection caused by C. lusitaniae after laparoscopic hydrosalpinx surgery. The patient was treated with fluconazole according to susceptibility testing. Fluconazole was implemented both orally and by transvaginal injection into the space after the evacuated pseudocyst. Conservative treatment resulted in a temporary improvement of the patient’s condition and a reduction of the pseudocyst.Candida lusitaniae is very similar to other Candida species in generating systemic and local infections – mainly in compromised patients. It is also unique in its ability to develop resistance to AmB. Proper identification and quick implementation of selective therapy with the right anti-fungal drug are crucial for successfully treating infected patients. Surgery should always be considered as a final treatment option.

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Intra-abdominalCandidaspp infection in acute abdomen in a quality assurance (QA)-certified academic setting

Cited by 8 publications

References 43 publications

Open Abdomen Management and Candida Infections: A Very Likely Link

Open Abdomen Management and Candida Infections: A Very Likely Link

Infective Endocarditis: Preliminary Results of a Cohort Study in the Southern Italian Population

Candida lusitaniae – a case report of an intraperitoneal infection

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