This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (19)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Critical Care/ Intensive Care Medicine  • Surgical Infections  • Prognosis/ Outcomes  • Infectious Diseases  • Alert me on articles by topic  Social Bookmarking   What's this?

Hervé Dupont, MD; Catherine Paugam-Burtz, MD; Claudette Muller-Serieys, MD; Lisiane Fierobe, MD; Denis Chosidow, MD; Jean-Pierre Marmuse, MD; Jean Mantz, MD,PhD; Jean-Marie Desmonts, MD

Arch Surg. 2002;137:1341-1346.

Background  Candida peritonitis (CP) is generally considered to be a severe disease, but its impact on outcome in critically ill patients remains unknown.

Hypothesis  The predictive factors of mortality due to CP can be determined by study of a population of patients with CP.

Design  A retrospective review of a prospective surgical intensive care unit (ICU) database of patients (January 1, 1994, through December 31, 2000).

Setting  University hospital in Paris, France.

Patients  Eighty-three patients with generalized CP.

Main Outcome Measures  Demographic and microbiologic data and outcome were collected, and nonsurvivors were compared with survivors.

Results  Overall ICU mortality due to CP was 43 (52%) of 83 patients. In a stepwise multivariate logistic regression, the following 4 variables were independently associated with mortality: APACHE II (Acute Physiology and Chronic Health Evaluation II) score on admission of at least 17 (odds ratio [OR], 28.4; 95% confidence interval [CI], 5.7-142.5; P<.001), respiratory failure on admission (OR, 10.6; 95% CI, 2.2-51.2; P = .003), upper gastrointestinal tract site of peritonitis (OR, 7.7; 95% CI, 1.7-34.7; P = .007), and results of direct examination of peritoneal fluid that were positive for Candida (OR, 4.7; 95% CI, 1.2-19.7; P = .002).

Conclusions  These results confirm the severity of CP in ICU patients and emphasize the prognostic value of direct examination of peritoneal fluid for Candida in this context.

From the Departments of Anesthesiology and Surgical Intensive Care Unit (Drs Dupont, Paugam-Burtz, Fierobe, Mantz, and Desmonts), Microbiology (Dr Muller-Serieys), and General Surgery (Drs Chosidow and Marmuse), University Hospital Bichat-Claude Bernard, Paris, France.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati     What's this?

RELATED ARTICLE

Predictive Factors of Mortality Due to Polymicrobial Peritonitis With Candida Isolation in Peritoneal Fluid in Critically Ill Patients—Invited Critique
Joseph S. Solomkin
Arch Surg. 2002;137(12):1347.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Mannose-Binding Lectin Deficiency Facilitates Abdominal Candida Infections in Patients with Secondary Peritonitis
van Till et al.
CVI 2008;15:65-70.
ABSTRACT | FULL TEXT  

Serum and intraperitoneal levels of amphotericin B and flucytosine during intravenous treatment of critically ill patients with Candida peritonitis
van der Voort et al.
J Antimicrob Chemother 2007;59:952-956.
ABSTRACT | FULL TEXT  

Fluconazole for the management of invasive candidiasis: where do we stand after 15 years?
Charlier et al.
J Antimicrob Chemother 2006;57:384-410.
ABSTRACT | FULL TEXT