Scholarlink

Purpose <p>Recent changes in the mycological profile have been reported in several life-threatening infections, but no data have assessed this issue in postoperative peritonitis (POP).</p> Methods <p>This retrospective monocentric analysis (1999–2019) evaluated the temporal changes of fungi collected from POP samples in intensive care unit (ICU) patients and assessed the adequacy of antifungal therapy (AFT) and the prognosis.</p> Results <p>Overall, 1,389 microorganisms were cultured from surgical samples in 464 ICU patients, including 186 (40%) patients harbouring fungi (11 fungaemia). Growing proportions of fungi were observed over time (<i>p</i> &lt; 0.01), related to increased rates of <i>Candida albicans</i> and <i>C. non-albicans</i> (<i>p</i> = 0.01 and <i>p</i> &lt; 0.01, respectively). A significantly increased prescription of empirical AFT was observed during the study period (<i>p</i> &lt; 0.0001). Adequate empirical AFT was achieved in 93/186 (50%) patients in the fungal group. Documented AFT was given in 163/174 (94%) patients in the fungal group for a median duration of 14 [9–21] days, mainly with fluconazole. The ICU and hospital mortality rates were similar in bacterial and fungal groups. However, we observed a significant increase in the duration of mechanical ventilation and ICU stay in the fungal group.</p> Conclusion <p>We observed high and growing proportions of fungi in patients treated for POP associated to increasing proportions of both <i>C. albicans</i> and <i>C. non-albicans</i>. Adequate AFT was achieved in all cases with caspofungin, but fluconazole remains an acceptable option for de-escalation. Our data suggest that, in ICU patients with POP, the severity of illness, rather than adequate AFT, drives clinical outcomes.</p> Graphical abstract <p></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Temporal changes in fungal epidemiology in ICU post-operative peritonitis cases

  • 期刊论文

  • 发表日期：

    2025年11月6日

查看全文
  • Philippe Montravers,
  • Christine Bonnal,
  • Stefan Andrei,
  • Pascal Augustin,
  • Nathalie Grall,
  • Nathalie Zappella

摘要

Purpose

Recent changes in the mycological profile have been reported in several life-threatening infections, but no data have assessed this issue in postoperative peritonitis (POP).

Methods

This retrospective monocentric analysis (1999–2019) evaluated the temporal changes of fungi collected from POP samples in intensive care unit (ICU) patients and assessed the adequacy of antifungal therapy (AFT) and the prognosis.

Results

Overall, 1,389 microorganisms were cultured from surgical samples in 464 ICU patients, including 186 (40%) patients harbouring fungi (11 fungaemia). Growing proportions of fungi were observed over time (p < 0.01), related to increased rates of Candida albicans and C. non-albicans (p = 0.01 and p < 0.01, respectively). A significantly increased prescription of empirical AFT was observed during the study period (p < 0.0001). Adequate empirical AFT was achieved in 93/186 (50%) patients in the fungal group. Documented AFT was given in 163/174 (94%) patients in the fungal group for a median duration of 14 [9–21] days, mainly with fluconazole. The ICU and hospital mortality rates were similar in bacterial and fungal groups. However, we observed a significant increase in the duration of mechanical ventilation and ICU stay in the fungal group.

Conclusion

We observed high and growing proportions of fungi in patients treated for POP associated to increasing proportions of both C. albicans and C. non-albicans. Adequate AFT was achieved in all cases with caspofungin, but fluconazole remains an acceptable option for de-escalation. Our data suggest that, in ICU patients with POP, the severity of illness, rather than adequate AFT, drives clinical outcomes.

Graphical abstract