Vaclava Adamkova
Clinical Microbiology and ATB centre, Czech Republic
Title: Intraabdominal candidiasis – myth or fact?
Biography
Biography: Vaclava Adamkova
Abstract
Intraabdominal candidiasis (IAC) is the predominant type of invasive candidiasis after candidemia. IAC is associated with mortality rates around 25–60 % . The majority of epidemiological studies on Candida are focused only on bloodstream infections. Nevertheless, the role of blood cultures has a limited application in patients with abdominal candidiasis. IAC, which includes peritonitis and intraabdominal abscesses, may occur in around 40 % of patients following repeat gastrointestinal (GI) surgery, GI perforation, or necrotizing pancreatitis. Candida is reported to be isolated in 41 % of upper gastrointestinal (GI) sites, 35 % of small bowel, 12 % of colorectal, and less than 5 % of appendicular sites in. Candida spp. has been reported as the second most frequent pathogen cultured in peritonitis patients Major risk factors for Candida peritonitis include hollow organ perforation, abdominal and thoracic surgery, surgical drains in situ, intravenous and urinary catheters, severe sepsis, and extensive Candida colonization. For many years, there has been debate over the importance of Candida isolated from the sites of intraabdominal infection. The organism is a part of normal flora of the gastrointestinal tract and its isolation is often difficult to interpret. Unfortunately, the pathophysiologic importance of Candida isolation from the abdominal space is by far not clear in many clinical situations. Generally, infection is suspected when the organism is cultured from samples obtained intraoperatively or directly from an intraabdominal collection. When Candida is cultured from subsequently obtained drainage fluid samples, colonization is a possibility