Potential Influence of Antisecretory Therapy on the Development of Candida-Associated Intraabdominal Infection

Cat, Tram B.; Charash, William E.; Hebert, James C.; Marden, Brian T; Corbett, Stephanie Mallow; Ahern, John W.; Rebuck, Jill A.

doi:10.1345/aph.1k328

Cited by 8 publications

(1 citation statement)

References 28 publications

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“… 33 , 38 – 40 Moreover, PPI intake has been proposed as a risk factor for Candida esophagitis in immunocompetent individuals, and case-controlled studies have indicated that chronic PPI use might be a predisposing factor to Candida-associated intra-abdominal infections. 41 , 42 PPIs are widely used drugs in clinical practice, and the rate of inappropriate prescriptions without indication is high. Our data implicate that particularly in patients with PSC, a critical evaluation of the indication for PPI is necessary to avoid biliary candidiasis and further disease progression.…”

Section: Discussionmentioning

confidence: 99%

Biliary microbial patterns in primary sclerosing cholangitis are linked to poorer transplant-free survival

Özdirik,

Scherf,

Brumercek

et al. 2023

Hepatology Communications

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Background: Factors that determine individual disease course of patients with primary sclerosing cholangitis (PSC) are poorly understood. Although an association between gut microbes and disease outcome has been suggested, little is known about the role of microbes in the biliary tract. Methods: We analyzed microbial cultures from bile specimens obtained during routine endoscopic retrograde cholangiopancreatography (ERCP) and intraoperatively before liver transplantation in 114 patients with PSC in our tertiary academic center. The presence of bacterial and fungal species was correlated with clinical characteristics and outcome data. Results: A total of 87 patients (76%) had positive bile culture results. The presence of concomitant inflammatory bowel disease (IBD) was associated with positive bile culture results in multivariate analysis (OR, 4.707; 95% CI, 1.688–13.128; p=0.003). Enterococcus spp. in the bile was associated with a more frequent occurrence of liver transplantation and/or death (OR, 2.778; 95% CI, 1.147–6.728; p=0.021) and recurrent (≥3) cholangitis episodes (OR, 2.839; 95% CI, 1.037–7.768; p=0.037). Biliary candidiasis was linked to a higher frequency of recurrent (≥3) cholangitis episodes (OR, 5.677; 95% CI, 1.940–16.616; p=0.001). Proton pump inhibitor intake conferred a clinical feature associated with biliary candidiasis in multivariate analysis (OR, 3.559; 95% CI, 1.275–9.937; p=0.016). Conclusions: Our data indicate that in patients with PSC, presence of Enterococcus spp. and Candida spp. in bile is associated with an adverse outcome. Concomitant IBD is linked to presence of microbes in bile, and proton pump inhibitor intake is a feature associated with biliary candidiasis in patients with PSC.

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Section: Discussionmentioning

confidence: 99%

Biliary microbial patterns in primary sclerosing cholangitis are linked to poorer transplant-free survival

Özdirik,

Scherf,

Brumercek

et al. 2023

Hepatology Communications

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Malignant tumor-like gastric lesion due to candida albicans in a diabetic patient treated with cyclosporin: a case report and review of the literature

et al. 2011

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The gastrointestinal tract of healthy individuals is colonized by hundreds of saprophytes and mycetes, especially the Candida species, are habitual ones. Under certain conditions, the fungal flora may overgrow, resulting in lesions of the digestive mucosa which, rarely, can have a local diffusion and/or spread to the lympho-hematogenous system. Mycotic infections of the stomach can sometimes look like benign gastric ulcers. Here, we present the case report of a woman, aged 64, who presented with type II diabetes mellitus and psoriasis, on chronic treatment with cyclosporin A and with endoscopic evidence of an ulcerated, vegetating gastric lesion secondary to Candida albicans infection. Although strongly suggestive of malignancy, it completely healed after cyclosporin withdrawal and the administration of oral antifungal drugs.

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Acid-Suppressive Therapy and Risk of Infections: Pros and Cons

Fisher

2017

Clin Drug Investig

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This narrative review summarises the benefits, risks and appropriate use of acid-suppressing drugs (ASDs), proton pump inhibitors and histamine-2 receptor antagonists, advocating a rationale balanced and individualised approach aimed to minimise any serious adverse consequences. It focuses on current controversies on the potential of ASDs to contribute to infections-bacterial, parasitic, fungal, protozoan and viral, particularly in the elderly, comprehensively and critically discusses the growing body of observational literature linking ASD use to a variety of enteric, respiratory, skin and systemic infectious diseases and complications (Clostridium difficile diarrhoea, pneumonia, spontaneous bacterial peritonitis, septicaemia and other). The proposed pathogenic mechanisms of ASD-associated infections (related and unrelated to the inhibition of gastric acid secretion, alterations of the gut microbiome and immunity), and drug-drug interactions are also described. Both probiotics use and correcting vitamin D status may have a significant protective effect decreasing the incidence of ASD-associated infections, especially in the elderly. Despite the limitations of the existing data, the importance of individualised therapy and caution in long-term ASD use considering the balance of benefits and potential harms, factors that may predispose to and actions that may prevent/attenuate adverse effects is evident. A six-step practical algorithm for ASD therapy based on the best available evidence is presented.

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Potential Influence of Antisecretory Therapy on the Development of Candida-Associated Intraabdominal Infection

Cited by 8 publications

References 28 publications

Biliary microbial patterns in primary sclerosing cholangitis are linked to poorer transplant-free survival

Biliary microbial patterns in primary sclerosing cholangitis are linked to poorer transplant-free survival

Malignant tumor-like gastric lesion due to candida albicans in a diabetic patient treated with cyclosporin: a case report and review of the literature

Acid-Suppressive Therapy and Risk of Infections: Pros and Cons

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