CLINICAL-SIGNIFICANCE OF CANDIDA ISOLATED FROM PERITONEUM IN SURGICAL PATIENTS
CLINICAL-SIGNIFICANCE OF CANDIDA ISOLATED FROM PERITONEUM IN SURGICAL PATIENTS
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DOI：
10.1016/s0140-6736(89)92043-6
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发表时间：
1989-12-16
期刊：
影响因子：
168.9
通讯作者：
FRANCIOLI, P
中科院分区：
文献类型：
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作者：
CALANDRA, T;SCHNEIDER, R;FRANCIOLI, P
在两年的时间里，对所有从腹部标本中分离出念珠菌的外科患者进行了评估。在49名可评估的患者中，除1名外，所有患者要么是自发性穿孔(57%)，要么是胃肠道手术开口(41%)。念珠菌感染19例(39%)，其中腹内脓肿7例，腹膜炎12例。在其他30名患者(61%)中，没有感染的迹象，也不需要特殊的手术或药物治疗。在接受急性胰腺炎手术的患者中分离出念珠菌时，比那些胃肠道穿孔或其他手术条件的患者更有可能导致感染。临床感染的发生与半定量培养中初始念珠菌数量高或数量增加显著相关。单独手术失败16或19例(84%)，其中7例死亡，9例经抗真菌和手术联合治疗后痊愈。腹内念珠菌感染患者的总病死率和感染相关病死率明显高于无腹内感染的患者。
Over a 2-year period, all surgical patients from whom Candida was isolated from intra-abdominal specimens were evaluated. All but 1 of the 49 evaluable patients had either a spontaneous perforation (57%) or a surgical opening of the gastrointestinal tract (41%). Candida caused infection in 19 patients (39%), of whom 7 had an intra-abdominal abscess and 12 peritonitis. In the other 30 patients (61%), there were no signs of infection and specific surgical or medical treatment was not required. Candida was more likely to cause infection when isolated in patients having surgery for acute pancreatitis than in those with either gastrointestinal perforations or other surgical conditions. The development of a clinical infection was significantly associated with a high initial or increasing amount of Candida in the semiquantitative culture. Surgery alone failed in 16 or 19 patients (84%), of whom 7 died and 9 recovered after combined antifungal and surgical treatment. The overall mortality and the mortality related to infections were significantly higher in the patients with intraabdominal candidal infections than in those without such infections.