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Volume 42, Number 5, October 2009

Prognostic factors for patiens with culture-positive Candida infection udergoing abdominal surgery


Feng-Chien Hsu, Po-Chang Lin, Chih-Yu Chi, Mao-Wang ho, Cheng-Mao Ho, Jen-Hsien Wang


Received: May 1, 2008    Revised: June 6, 2008    Accepted: July 31, 2008   

 

Corresponding author:

Dr. Jen-Hsien Wang, Section of Infectious Diseases, Department of Internal Medicine, China medical University Hospital, No. 2, Yude Rd, North District, Taichung 404, Taiwan. Email: jenhsien@www.cmuh.org.tw



 

Background and purpose: 

Increased risk for fungal infections has been observed in high-risk surgical patients, but the prognostic factors and impact of antifungal agents in this patient population are uncertain, especially in patients undergoing abdominal operation. This study was performed to ascertain the prognostic factors for patients with culture-positive Candida spp. who have had abdominal surgery.



 

Methods:

From 2003 through 2006, all adult patients with positive candidal culture from abdominal specimens (peritoneal fluid obtained during laparotomy or drain effluent, abscess, or bile) at China Medical Uiversity Hosptial, Taichung, Taiwan, were included in this retrospective study. Patients' demographic data, progostic factors, and 30-day mortality rate related to fungal infection were analyzed by reviewing the medical charts.



 

Results:

Thirty nine patients were enrolled in the study. The overall mortality rate was 35.9%. Candida albicans was the most common isolate (82.5%). The major prognostic factors were number of surgical interventions, Gram-negative bacteremia, high Acute Physiology And Chronic Health Evaluation ( APACHE) II score, corticosteroid use, and subsequent candidal infection (p<0.05).



 

Conclusion:

In patients with positive intro-abdominal candidal culture, greater numbers of surgical intervention, Gram-negative bacilli bactermia, and high APACHE II score were the prognostic factors for mortality. Corticosteroid use might be a risk factor for subsequent candidal infection



 

Key words:

Candida; Prognosis; Risk factors; Surgical procedures, operative