Candidiasis peritoneal: prevalencia y factores de riesgo / Candida peritonitis: prevalence and risk factors

Antecedentes. La obtención de un cultivo positivo de líquido peritoneal para Candida en pacientes con clínica asociada permite establecer el diagnóstico de candidiasis peritoneal (CP), etiología relacionada con mal pronóstico. Es importante conocer sus factores de riesgo y así comenzar un tratamiento empírico precoz. Los pacientes que reciben tratamiento antibiótico prolongado, la infección nosocomial, el género femenino, la afectación del tracto gastrointestinal superior (TGIS) y la existencia de fallo cardiovascular intraoperatorio (FCVI) son los factores de riesgo que se han relacionado con dicha peritonitis. Objetivos. El objetivo principal fue conocer la prevalencia de CP en nuestro hospital y, como objetivos secundarios, relacionar los posibles factores de riesgo asociados. Métodos. Se recoge una muestra de 74 pacientes con diagnóstico de peritonitis, de manera consecutiva, entre 2007 y 2010. Durante el acto quirúrgico se aspira líquido peritoneal libre y se procede a su cultivo. Resultados. La prevalencia de CP obtenida en nuestro hospital es del 17,6%, de la cual el 46,15% de los casos corresponden a Candida albicans. Podemos considerar factores de riesgo para el desarrollo de dicha enfermedad la afectación del TGIS y la aparición de FCVI. La edad, el sexo, la infección nosocomial y el tratamiento antibiótico previo no parecen considerarse factores de riesgo para la misma. Conclusiones. La prevalencia de CP es del 17,6%. Los factores de riesgo que predispondrían son la afectación del TGIS como origen de la peritonitis y el FCVI durante el acto quirúrgico (AU)

Background: A peritoneal fluid with a positive culture for Candida in patients with associated clinical symptoms enables peritoneal candidiasis (PC) to be diagnosed. This etiology is related to a poor prognosis, thus, it is important to know all the risk factors and to start early an empirical treatment. The risk factors associated with this kind of peritonitis are to receive prolonged antibiotic treatment, nosocomial infection, female gender, involvement of the upper gastro-intestinal (UGI) tract, and the ocurrence of an intraoperative cardiovascular failure (CVF). Aims: The principal aim was to determine the prevalence of PC in our hospital, and the secondary aims to determine the associated risk factors. Methods: We obtained samples from 74 patients diagnosed with peritonitis, consecutively from 2007 to 2010. Cultures were performed with the free peritoneal fluid aspirated during surgery. Results: The prevalence of PC obtained in our hospital was 17.6%, from which 46.15% corresponded to Candida albicans. The involvement of the UGI tract and the onset of CVF can be considered risk factors for the development of this pathology. Age, gender, nosocomial infection and previous antibiotic treatment were not related to this pathology. Conclusions: Our prevalence of PC is 17.6%. The risk factors that could predispose are the involvement of the UGI tract as the cause of peritonitis, and CVF during surgical procedure (AU)

[Candida peritonitis: Prevalence and risk factors]. / Candidiasis peritoneal: prevalencia y factores de riesgo.

BACKGROUND: A peritoneal fluid with a positive culture for Candida in patients with associated clinical symptoms enables peritoneal candidiasis (PC) to be diagnosed. This etiology is related to a poor prognosis, thus, it is important to know all the risk factors and to start early an empirical treatment. The risk factors associated with this kind of peritonitis are to receive prolonged antibiotic treatment, nosocomial infection, female gender, involvement of the upper gastro-intestinal (UGI) tract, and the ocurrence of an intraoperative cardiovascular failure (CVF). AIMS: The principal aim was to determine the prevalence of PC in our hospital, and the secondary aims to determine the associated risk factors. METHODS: We obtained samples from 74 patients diagnosed with peritonitis, consecutively from 2007 to 2010. Cultures were performed with the free peritoneal fluid aspirated during surgery. RESULTS: The prevalence of PC obtained in our hospital was 17.6%, from which 46.15% corresponded to Candida albicans. The involvement of the UGI tract and the onset of CVF can be considered risk factors for the development of this pathology. Age, gender, nosocomial infection and previous antibiotic treatment were not related to this pathology. CONCLUSIONS: Our prevalence of PC is 17.6%. The risk factors that could predispose are the involvement of the UGI tract as the cause of peritonitis, and CVF during surgical procedure.