Candidemia indicates poor outcome in patients with infected pancreatic necrosis
Background Intra‐abdominal fungal infection (AFI) and candidemia are common in patients with acute pancreatitis (AP), but with limited and conflicting reports on their clinical impacts. This study aims to evaluate the clinical impacts of AFI and candidemia in infected pancreatic necrosis (IPN). Meth...
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| Veröffentlicht in: | Mycoses 2021-06, Vol.64 (6), p.684-690 |
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| creator | Ning, Caihong Zhu, Shuai Wei, Qin Liu, Zhiyong Lin, Chiayen Li, Jiarong Cao, Xintong Bonsu, Abdul Aziz F. K. Shen, Dingcheng Peng, Milin Huang, Gengwen |
| description | Background
Intra‐abdominal fungal infection (AFI) and candidemia are common in patients with acute pancreatitis (AP), but with limited and conflicting reports on their clinical impacts. This study aims to evaluate the clinical impacts of AFI and candidemia in infected pancreatic necrosis (IPN).
Methods
A single‐centre, prospective cohort including 235 consecutive patients with IPN between January 2010 and September 2020 was analysed to study the clinical impacts of AFI and candidemia.
Results
Of the 235 patients with IPN, 69 patients (29.4%) developed AFI and 13 patients (5.5%) developed candidemia. AFI was associated with higher intestinal leakage rate (27.5% vs 12.7%, P = .006), higher pancreatic fistula rate (53.6% vs 34.3%, P = .006) and longer hospital stays (72 vs 58 days, P = .003), but with similar mortality rate compared with patients without AFI (23.2% vs 24.7%, P = .806). However, candidemia was associated with significantly higher mortality rate compared with patients without candidemia (69.2% vs 21.6%, P |
| doi_str_mv | 10.1111/myc.13266 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2500374282</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2524041135</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3536-e778377a7444928e252b4dcbaa3bb578564afc753f77d95e65f826a81cae4d913</originalsourceid><addsrcrecordid>eNp1kE1Lw0AQhhdRbK0e_AMS8KKHtPu9yVGCX1DpRQ-ewmYzwS35qLsJpf_erakeBOcywzsPLzMvQpcEz0moRbMzc8KolEdoSjhLYyywOkZTnDIWK47VBJ15v8aYqJTKUzRhTKacpMkUrTLdlraExurIhsnoHny06ToXdUNvugaCHG10b6HtfbS1_UcQKjA9lEFujYOwM1ELxnXe-nN0Uunaw8Whz9Dbw_1r9hQvV4_P2d0yNkwwGYNSCVNKK855ShOggha8NIXWrCiESoTkujJKsEqpMhUgRZVQqRNiNPAyJWyGbkbfjes-B_B93lhvoK51C93gcyowZorThAb0-g-67gbXhusCRTnmhISbZuh2pPZ_eAdVvnG20W6XE5zvU85Dyvl3yoG9OjgORQPlL_kTawAWI7C1Nez-d8pf3rPR8gufjIXV</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2524041135</pqid></control><display><type>article</type><title>Candidemia indicates poor outcome in patients with infected pancreatic necrosis</title><source>Wiley-Blackwell Journals</source><creator>Ning, Caihong ; Zhu, Shuai ; Wei, Qin ; Liu, Zhiyong ; Lin, Chiayen ; Li, Jiarong ; Cao, Xintong ; Bonsu, Abdul Aziz F. K. ; Shen, Dingcheng ; Peng, Milin ; Huang, Gengwen</creator><creatorcontrib>Ning, Caihong ; Zhu, Shuai ; Wei, Qin ; Liu, Zhiyong ; Lin, Chiayen ; Li, Jiarong ; Cao, Xintong ; Bonsu, Abdul Aziz F. K. ; Shen, Dingcheng ; Peng, Milin ; Huang, Gengwen</creatorcontrib><description>Background
Intra‐abdominal fungal infection (AFI) and candidemia are common in patients with acute pancreatitis (AP), but with limited and conflicting reports on their clinical impacts. This study aims to evaluate the clinical impacts of AFI and candidemia in infected pancreatic necrosis (IPN).
Methods
A single‐centre, prospective cohort including 235 consecutive patients with IPN between January 2010 and September 2020 was analysed to study the clinical impacts of AFI and candidemia.
Results
Of the 235 patients with IPN, 69 patients (29.4%) developed AFI and 13 patients (5.5%) developed candidemia. AFI was associated with higher intestinal leakage rate (27.5% vs 12.7%, P = .006), higher pancreatic fistula rate (53.6% vs 34.3%, P = .006) and longer hospital stays (72 vs 58 days, P = .003), but with similar mortality rate compared with patients without AFI (23.2% vs 24.7%, P = .806). However, candidemia was associated with significantly higher mortality rate compared with patients without candidemia (69.2% vs 21.6%, P < .001). Patients with candidemia had higher rate of multiple organ failure and AFI (69.2% vs 36.5%, P = .018; 69.2% vs 27.0%, P = .001, respectively). Multivariable analysis showed that age ≥ 50 years (OR = 2.8; 95% CI, 1.3‐5.8; P = .007), severe category (OR = 11.2; 95% CI, 3.5‐35.7; P < .001), multidrug‐resistant organisms infection (OR = 2.5; 95% CI, 1.0‐6.2; P = .039), candidemia (OR = 11.8; 95% CI, 2.5‐56.5; P = .002), step‐down surgical approach (OR = 3.2; 95% CI, 1.5‐7.0; P = .004) were the independent predictors associated with higher mortality in IPN patients.
Conclusion
Although AFI did not increase the mortality of IPN, patients with candidemia carried significantly higher mortality.</description><identifier>ISSN: 0933-7407</identifier><identifier>EISSN: 1439-0507</identifier><identifier>DOI: 10.1111/myc.13266</identifier><identifier>PMID: 33694198</identifier><language>eng</language><publisher>Germany: Wiley Subscription Services, Inc</publisher><subject>acute pancreatitis ; Candidemia ; Intestine ; intra‐abdominal fungal infection ; Mortality ; Necrosis ; Pancreas ; Pancreatitis ; Patients</subject><ispartof>Mycoses, 2021-06, Vol.64 (6), p.684-690</ispartof><rights>2021 Wiley‐VCH GmbH</rights><rights>2021 Wiley-VCH GmbH.</rights><rights>2021 Blackwell Verlag GmbH</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3536-e778377a7444928e252b4dcbaa3bb578564afc753f77d95e65f826a81cae4d913</citedby><cites>FETCH-LOGICAL-c3536-e778377a7444928e252b4dcbaa3bb578564afc753f77d95e65f826a81cae4d913</cites><orcidid>0000-0001-9906-6904</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fmyc.13266$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fmyc.13266$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33694198$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ning, Caihong</creatorcontrib><creatorcontrib>Zhu, Shuai</creatorcontrib><creatorcontrib>Wei, Qin</creatorcontrib><creatorcontrib>Liu, Zhiyong</creatorcontrib><creatorcontrib>Lin, Chiayen</creatorcontrib><creatorcontrib>Li, Jiarong</creatorcontrib><creatorcontrib>Cao, Xintong</creatorcontrib><creatorcontrib>Bonsu, Abdul Aziz F. K.</creatorcontrib><creatorcontrib>Shen, Dingcheng</creatorcontrib><creatorcontrib>Peng, Milin</creatorcontrib><creatorcontrib>Huang, Gengwen</creatorcontrib><title>Candidemia indicates poor outcome in patients with infected pancreatic necrosis</title><title>Mycoses</title><addtitle>Mycoses</addtitle><description>Background
Intra‐abdominal fungal infection (AFI) and candidemia are common in patients with acute pancreatitis (AP), but with limited and conflicting reports on their clinical impacts. This study aims to evaluate the clinical impacts of AFI and candidemia in infected pancreatic necrosis (IPN).
Methods
A single‐centre, prospective cohort including 235 consecutive patients with IPN between January 2010 and September 2020 was analysed to study the clinical impacts of AFI and candidemia.
Results
Of the 235 patients with IPN, 69 patients (29.4%) developed AFI and 13 patients (5.5%) developed candidemia. AFI was associated with higher intestinal leakage rate (27.5% vs 12.7%, P = .006), higher pancreatic fistula rate (53.6% vs 34.3%, P = .006) and longer hospital stays (72 vs 58 days, P = .003), but with similar mortality rate compared with patients without AFI (23.2% vs 24.7%, P = .806). However, candidemia was associated with significantly higher mortality rate compared with patients without candidemia (69.2% vs 21.6%, P < .001). Patients with candidemia had higher rate of multiple organ failure and AFI (69.2% vs 36.5%, P = .018; 69.2% vs 27.0%, P = .001, respectively). Multivariable analysis showed that age ≥ 50 years (OR = 2.8; 95% CI, 1.3‐5.8; P = .007), severe category (OR = 11.2; 95% CI, 3.5‐35.7; P < .001), multidrug‐resistant organisms infection (OR = 2.5; 95% CI, 1.0‐6.2; P = .039), candidemia (OR = 11.8; 95% CI, 2.5‐56.5; P = .002), step‐down surgical approach (OR = 3.2; 95% CI, 1.5‐7.0; P = .004) were the independent predictors associated with higher mortality in IPN patients.
Conclusion
Although AFI did not increase the mortality of IPN, patients with candidemia carried significantly higher mortality.</description><subject>acute pancreatitis</subject><subject>Candidemia</subject><subject>Intestine</subject><subject>intra‐abdominal fungal infection</subject><subject>Mortality</subject><subject>Necrosis</subject><subject>Pancreas</subject><subject>Pancreatitis</subject><subject>Patients</subject><issn>0933-7407</issn><issn>1439-0507</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp1kE1Lw0AQhhdRbK0e_AMS8KKHtPu9yVGCX1DpRQ-ewmYzwS35qLsJpf_erakeBOcywzsPLzMvQpcEz0moRbMzc8KolEdoSjhLYyywOkZTnDIWK47VBJ15v8aYqJTKUzRhTKacpMkUrTLdlraExurIhsnoHny06ToXdUNvugaCHG10b6HtfbS1_UcQKjA9lEFujYOwM1ELxnXe-nN0Uunaw8Whz9Dbw_1r9hQvV4_P2d0yNkwwGYNSCVNKK855ShOggha8NIXWrCiESoTkujJKsEqpMhUgRZVQqRNiNPAyJWyGbkbfjes-B_B93lhvoK51C93gcyowZorThAb0-g-67gbXhusCRTnmhISbZuh2pPZ_eAdVvnG20W6XE5zvU85Dyvl3yoG9OjgORQPlL_kTawAWI7C1Nez-d8pf3rPR8gufjIXV</recordid><startdate>202106</startdate><enddate>202106</enddate><creator>Ning, Caihong</creator><creator>Zhu, Shuai</creator><creator>Wei, Qin</creator><creator>Liu, Zhiyong</creator><creator>Lin, Chiayen</creator><creator>Li, Jiarong</creator><creator>Cao, Xintong</creator><creator>Bonsu, Abdul Aziz F. K.</creator><creator>Shen, Dingcheng</creator><creator>Peng, Milin</creator><creator>Huang, Gengwen</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>M7N</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9906-6904</orcidid></search><sort><creationdate>202106</creationdate><title>Candidemia indicates poor outcome in patients with infected pancreatic necrosis</title><author>Ning, Caihong ; Zhu, Shuai ; Wei, Qin ; Liu, Zhiyong ; Lin, Chiayen ; Li, Jiarong ; Cao, Xintong ; Bonsu, Abdul Aziz F. K. ; Shen, Dingcheng ; Peng, Milin ; Huang, Gengwen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3536-e778377a7444928e252b4dcbaa3bb578564afc753f77d95e65f826a81cae4d913</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>acute pancreatitis</topic><topic>Candidemia</topic><topic>Intestine</topic><topic>intra‐abdominal fungal infection</topic><topic>Mortality</topic><topic>Necrosis</topic><topic>Pancreas</topic><topic>Pancreatitis</topic><topic>Patients</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ning, Caihong</creatorcontrib><creatorcontrib>Zhu, Shuai</creatorcontrib><creatorcontrib>Wei, Qin</creatorcontrib><creatorcontrib>Liu, Zhiyong</creatorcontrib><creatorcontrib>Lin, Chiayen</creatorcontrib><creatorcontrib>Li, Jiarong</creatorcontrib><creatorcontrib>Cao, Xintong</creatorcontrib><creatorcontrib>Bonsu, Abdul Aziz F. K.</creatorcontrib><creatorcontrib>Shen, Dingcheng</creatorcontrib><creatorcontrib>Peng, Milin</creatorcontrib><creatorcontrib>Huang, Gengwen</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>MEDLINE - Academic</collection><jtitle>Mycoses</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ning, Caihong</au><au>Zhu, Shuai</au><au>Wei, Qin</au><au>Liu, Zhiyong</au><au>Lin, Chiayen</au><au>Li, Jiarong</au><au>Cao, Xintong</au><au>Bonsu, Abdul Aziz F. K.</au><au>Shen, Dingcheng</au><au>Peng, Milin</au><au>Huang, Gengwen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Candidemia indicates poor outcome in patients with infected pancreatic necrosis</atitle><jtitle>Mycoses</jtitle><addtitle>Mycoses</addtitle><date>2021-06</date><risdate>2021</risdate><volume>64</volume><issue>6</issue><spage>684</spage><epage>690</epage><pages>684-690</pages><issn>0933-7407</issn><eissn>1439-0507</eissn><abstract>Background
Intra‐abdominal fungal infection (AFI) and candidemia are common in patients with acute pancreatitis (AP), but with limited and conflicting reports on their clinical impacts. This study aims to evaluate the clinical impacts of AFI and candidemia in infected pancreatic necrosis (IPN).
Methods
A single‐centre, prospective cohort including 235 consecutive patients with IPN between January 2010 and September 2020 was analysed to study the clinical impacts of AFI and candidemia.
Results
Of the 235 patients with IPN, 69 patients (29.4%) developed AFI and 13 patients (5.5%) developed candidemia. AFI was associated with higher intestinal leakage rate (27.5% vs 12.7%, P = .006), higher pancreatic fistula rate (53.6% vs 34.3%, P = .006) and longer hospital stays (72 vs 58 days, P = .003), but with similar mortality rate compared with patients without AFI (23.2% vs 24.7%, P = .806). However, candidemia was associated with significantly higher mortality rate compared with patients without candidemia (69.2% vs 21.6%, P < .001). Patients with candidemia had higher rate of multiple organ failure and AFI (69.2% vs 36.5%, P = .018; 69.2% vs 27.0%, P = .001, respectively). Multivariable analysis showed that age ≥ 50 years (OR = 2.8; 95% CI, 1.3‐5.8; P = .007), severe category (OR = 11.2; 95% CI, 3.5‐35.7; P < .001), multidrug‐resistant organisms infection (OR = 2.5; 95% CI, 1.0‐6.2; P = .039), candidemia (OR = 11.8; 95% CI, 2.5‐56.5; P = .002), step‐down surgical approach (OR = 3.2; 95% CI, 1.5‐7.0; P = .004) were the independent predictors associated with higher mortality in IPN patients.
Conclusion
Although AFI did not increase the mortality of IPN, patients with candidemia carried significantly higher mortality.</abstract><cop>Germany</cop><pub>Wiley Subscription Services, Inc</pub><pmid>33694198</pmid><doi>10.1111/myc.13266</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-9906-6904</orcidid></addata></record> |
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| subjects | acute pancreatitis Candidemia Intestine intra‐abdominal fungal infection Mortality Necrosis Pancreas Pancreatitis Patients |
| title | Candidemia indicates poor outcome in patients with infected pancreatic necrosis |
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