Candida spp. infections after abdominal urgent surgery: comparative analysis of histologic data for which microbiological results were positive for Candida spp.

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Abstract

EV0515ePoster ViewingDiagnostic/laboratory methods other than molecularCandida spp. infections after abdominal urgent surgery: comparative analysis of histologic data for which microbiological results were positive for Candida spp.V. Rodolico1, G. Gulotta1, L. Montana1, G. Salamone1, D.C. Paola11Department of Sciences for Health Promotion and Mother Child Care, Palermo, ItalyObjectives: Microbiological identification is justified when the yeast is isolated from a sterile site, the potential clinical impact of identifiedisolates from non sterile sites such as intra- abdominal organs don’t help the clinicians to determine whether the strain isolate representscontamination, colonization, or true infection. To investigate the contribute of hystopathological investigations in surgical patients who survivethe initial postoperative period we compare histological and microbiological results positive for Candida spp. Methods: A retrospective studyof abdominal intraoperative tissue or biopsy specimens obtained from patients admitted for acute abdomen with post-operativemicrobiological samples positive for Candida spp was performed for the years January 2008 to December 2012. Specimens obtained fromautopsy cases were excluded. For each case, demographic data, mortality, comorbidity conditions, antimicrobial therapy, specimen type,the use of special histologic stains, any reported suggestion to correlate with or defer to microbiology, and the individual surgical pathologistwere recorded. Results: we evaluated 66 positive candida spp culture reports of which 56 had a concurrent surgical pathology specimen; ofthe 56 cases 5 were excluded because of a known history of fungal infection, among the remaining we selected 23 (15%) histologicalresults because in these patients clinical, microbiological and enventual other histopathological follow-up data were available. Table 1showed microbiological and hystopathological data. When other than blood culture specimens such as drainage were positive for candidainfection the result was suitable with histological picture. On the other hand, when the blood culture was positive the hystopathologicalresults (proliferative and granulomatous inflammation accompanied by numerous macrophages, lymphocytes, plasma cells andneutrophils) were compatible with the patients’ complications to confirm that Candida spp. is a frequent opportunistic pathogen especially incancer disease. In table we showed comparative analysis of 23 histologic data for which microbiological results were positive for Candidaspp.Microbiological SpecimenPositive for Candida spp (n) ConcordeHistological features Candida specie Comorbidity Outcome(Died)Blood 6 1 C. albicans=3C. nonalbicans=3 Cancer=5; Cholecistitis=1 3 (c.albican=2)Bile 4 / C. albicans=1C. nonalbicans=3Cancer=2Chronic gastritis pluscholecystitis =2Drainage 6 6 C. albicans=4C. nonalbicans=2 Cancer= 4Fistula=2 3 ( c.albicans)Biopsy 4 4 C. albicans=4C. nonalbicans= Cancer=2Fistula=2 1 (c. nonalbicans)Urine 1 1 C. albicansBile plus blood 2 2 C. albicansConclusions: Post- operative Candida spp infection is an important cause of morbidity and is frequently associated with poor prognosis,particularly in higher risk patients. Complicated intra-abdominal infections diagnosis is mainly a clinical diagnosis, therefore, low expansivesupplemental procedures for diagnosis, such as histopathology examination provide insight into the diagnostic significance of Candida sppisolated from surgical specimens other than blood samples.
Original languageEnglish
Number of pages1
Publication statusPublished - 2015

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