Candida isolation from peritoneal fluid: Its role in the outcome of patients with perforation peritonitis

Objective: Perforation peritonitis is a common surgical emergency which is treated bysurgery and antibiotics. Candida isolation in peritoneal fluid and antifungal treatment isnot a norm. The aim of this study was to determine the incidence of Candida in peritonealfluid and its role in the outcome of patients with perforation peritonitis.Methods: This prospective observational study was conducted on ۷۰ patients withperforation peritonitis from October ۲۰۱۶ to February ۲۰۱۸. Intraoperatively, peritonealfluid was taken and sent for microbiological culture and sensitivity. Perforation wasmanaged according to the site of perforation and condition of bowel.Results: The mean age of the patients was ۳۸.۷۴ years with male predominance (۵۸,۸۲.۸۵%). Forty-seven (۶۷.۱۴%) patients had positive peritoneal cultures. Escherichia coliwas the most common bacteria (n=۲۹), while Candida was found to be the most commonfungi and was found in ۱۸ patients. The incidence of Candida was higher in upper gastroduodenal perforation (۳۰, ۴۲.۸۵%). Patients found positive for Candida had APACHE IIseverity score ۱۰ or more which was higher than the rest of the patients. The mortality washigher in patients with positive peritoneal cultures (۱۰/۴۷) as compare to negative ones(۲/۲۳, P<۰.۰۰۱). The mortality in mixed bacterial and fungal-positive cultures (۷/۱۸) wasalso higher as compared to isolated bacterial culture (۳/۲۹, P <۰.۰۰۱). The overall mortalityrate was ۱۷.۱۴%.Conclusion: Patients with Candida positive peritoneal culture had a significant mortalityand morbidity as compared to Candida negative. Peritoneal fluid culture and sensitivity forbacterial and fungal were helpful in the early diagnosis and treatment

کلیدواژه ها:

Perforation peritonitis ، Candida ، Fungal peritonitis ، outcome ، Primary peritonitis ، Abdominal cavity ، laparotomy