Risk factors and prognoses of invasive Candida infection in surgical critical ill patients with perforated peptic ulcer
Background: The risk of invasive Candida infection (ICI) is high in patients with perforated peptic ulcer (PPU) who received laparotomy or laparoscopic surgery, but the risk factors and predictors of morbidity outcomes remain uncertain. This study aims to identify the risk factors of ICI in surgical...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-08-01
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| Series: | Journal of Microbiology, Immunology and Infection |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1684118222000275 |
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| author | Yia-Ting Li Yao-Chen Wang Shun-Fa Yang Yat-Yin Law Bei-Hao Shiu Te-An Chen Shih-Chi Wu Min-Chi Lu |
| author_facet | Yia-Ting Li Yao-Chen Wang Shun-Fa Yang Yat-Yin Law Bei-Hao Shiu Te-An Chen Shih-Chi Wu Min-Chi Lu |
| author_sort | Yia-Ting Li |
| collection | DOAJ |
| description | Background: The risk of invasive Candida infection (ICI) is high in patients with perforated peptic ulcer (PPU) who received laparotomy or laparoscopic surgery, but the risk factors and predictors of morbidity outcomes remain uncertain. This study aims to identify the risk factors of ICI in surgical critically ill PPU patients and to evaluate the impact on patient's outcomes. Methods: This is a single-center, retrospective study, with a total of 170 surgical critically ill PPU patients. Thirty-seven patients were ICI present and 133 were ICI absent subjects. The differences in pulmonary complications according to invasive candidiasis were determined by the Mann–Whitney U test. Evaluation of predictors contributing to ICI and 90-day mortality was conducted by using multivariate logistic regression analysis. Results: Candida albicans was the primary pathogen of ICI (74.29%). The infected patients had higher incidence of bacteremia (p < 0.001), longer intensive care unit (p < 0.001) and hospital (p < 0.001) stay, longer ventilator duration (p < 0.001) and increased hospital mortality (p = 0.02). In the multivariate analysis, serum lactate level measured at hospital admission was independently associated with the occurrence of ICI (p = 0.03). Liver cirrhosis (p = 0.03) and Sequential Organ Failure Assessment (SOFA) score (p = 0.007) were independently associated with the 90-day mortality. Conclusions: Blood lactate level measured at hospital admission could be a predictor of ICI and the surgical critically ill PPU patients with liver cirrhosis and higher SOFA score are associated with poor outcomes. |
| first_indexed | 2024-04-13T01:28:52Z |
| format | Article |
| id | doaj.art-bfbbfa627fda428aa536fda1210424a8 |
| institution | Directory Open Access Journal |
| issn | 1684-1182 |
| language | English |
| last_indexed | 2024-04-13T01:28:52Z |
| publishDate | 2022-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Microbiology, Immunology and Infection |
| spelling | doaj.art-bfbbfa627fda428aa536fda1210424a82022-12-22T03:08:33ZengElsevierJournal of Microbiology, Immunology and Infection1684-11822022-08-01554740748Risk factors and prognoses of invasive Candida infection in surgical critical ill patients with perforated peptic ulcerYia-Ting Li0Yao-Chen Wang1Shun-Fa Yang2Yat-Yin Law3Bei-Hao Shiu4Te-An Chen5Shih-Chi Wu6Min-Chi Lu7Institute of Medicine, Chung San Medical University, Taichung 402, Taiwan; Division of Respiratory Therapy, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, TaiwanSchool of Medicine, Chung Shan Medical University, Taichung, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, TaiwanInstitute of Medicine, Chung San Medical University, Taichung 402, Taiwan; Department of Medical Research, Chung Shan Medical University Hospital, Taichung, TaiwanInstitute of Medicine, Chung San Medical University, Taichung 402, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Orthopedics, Chung Shan Medical University Hospital, Taichung, TaiwanInstitute of Medicine, Chung San Medical University, Taichung 402, Taiwan; Division of Colon-Rectal Surgery, Department of Surgery, Chung Shan Medical University Hospital, Taichung, TaiwanDepartment of Surgery, China Medical University Hospital, Taichung, TaiwanSchool of Medicine, China Medical University, Taichung, Taiwan; Trauma and Emergency Center, China Medical University Hospital, Taichung, Taiwan; Corresponding author. Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan; Department of Microbiology and Immunology, School of Medicine, China Medical University, Taichung, Taiwan; Corresponding author. School of medicine, China Medical University, Taichung, Taiwan.Background: The risk of invasive Candida infection (ICI) is high in patients with perforated peptic ulcer (PPU) who received laparotomy or laparoscopic surgery, but the risk factors and predictors of morbidity outcomes remain uncertain. This study aims to identify the risk factors of ICI in surgical critically ill PPU patients and to evaluate the impact on patient's outcomes. Methods: This is a single-center, retrospective study, with a total of 170 surgical critically ill PPU patients. Thirty-seven patients were ICI present and 133 were ICI absent subjects. The differences in pulmonary complications according to invasive candidiasis were determined by the Mann–Whitney U test. Evaluation of predictors contributing to ICI and 90-day mortality was conducted by using multivariate logistic regression analysis. Results: Candida albicans was the primary pathogen of ICI (74.29%). The infected patients had higher incidence of bacteremia (p < 0.001), longer intensive care unit (p < 0.001) and hospital (p < 0.001) stay, longer ventilator duration (p < 0.001) and increased hospital mortality (p = 0.02). In the multivariate analysis, serum lactate level measured at hospital admission was independently associated with the occurrence of ICI (p = 0.03). Liver cirrhosis (p = 0.03) and Sequential Organ Failure Assessment (SOFA) score (p = 0.007) were independently associated with the 90-day mortality. Conclusions: Blood lactate level measured at hospital admission could be a predictor of ICI and the surgical critically ill PPU patients with liver cirrhosis and higher SOFA score are associated with poor outcomes.http://www.sciencedirect.com/science/article/pii/S1684118222000275Perforated peptic ulcerInvasive Candida infectionRisk factorsPrognoses |
| spellingShingle | Yia-Ting Li Yao-Chen Wang Shun-Fa Yang Yat-Yin Law Bei-Hao Shiu Te-An Chen Shih-Chi Wu Min-Chi Lu Risk factors and prognoses of invasive Candida infection in surgical critical ill patients with perforated peptic ulcer Journal of Microbiology, Immunology and Infection Perforated peptic ulcer Invasive Candida infection Risk factors Prognoses |
| title | Risk factors and prognoses of invasive Candida infection in surgical critical ill patients with perforated peptic ulcer |
| title_full | Risk factors and prognoses of invasive Candida infection in surgical critical ill patients with perforated peptic ulcer |
| title_fullStr | Risk factors and prognoses of invasive Candida infection in surgical critical ill patients with perforated peptic ulcer |
| title_full_unstemmed | Risk factors and prognoses of invasive Candida infection in surgical critical ill patients with perforated peptic ulcer |
| title_short | Risk factors and prognoses of invasive Candida infection in surgical critical ill patients with perforated peptic ulcer |
| title_sort | risk factors and prognoses of invasive candida infection in surgical critical ill patients with perforated peptic ulcer |
| topic | Perforated peptic ulcer Invasive Candida infection Risk factors Prognoses |
| url | http://www.sciencedirect.com/science/article/pii/S1684118222000275 |
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