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Colon Ascendens Stent Peritonitis (CASP) - a Standardized Model for Polymicrobial Abdominal Sepsis
06:45

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Mannose-binding lectin deficiency facilitates abdominal Candida infections in patients with secondary peritonitis

J W Olivier van Till1, Piet W Modderman, Martin de Boer

  • 1Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.

Clinical and Vaccine Immunology : CVI
|November 6, 2007
PubMed

Insights

Mannose-binding lectin (MBL) deficiency increases infection risk. Low MBL levels are linked to abdominal yeast infections in peritonitis patients, potentially facilitating early-stage infections.

Area of Science:

  • Immunology
  • Infectious Diseases
  • Gastroenterology

Background:

  • Mannose-binding lectin (MBL) deficiency, caused by MBL gene variations, is linked to heightened susceptibility to infections.
  • Peritonitis, particularly secondary peritonitis, presents a significant risk for serious infections, including fungal infections.

Purpose of the Study:

  • To investigate the association between MBL deficiency and the incidence of abdominal yeast infection (AYI) in patients with secondary peritonitis.
  • To identify risk factors for AYI in this patient population.

Main Methods:

  • A cohort of 88 patients with secondary peritonitis undergoing emergency laparotomy was studied.
  • MBL genotype, plasma MBL concentrations, and Candida risk factors were assessed in patients with and without AYI (confirmed by positive yeast cultures).

Main Results:

  • Patients with AYI showed a trend towards a higher prevalence of variant MBL genotypes (53% vs. 38%).
  • A significantly greater proportion of patients with variant MBL genotypes developed AYI during the initial laparotomy compared to wild-type patients (39% vs. 16%).
  • Lower MBL plasma levels (<0.5 microg/ml) were independently associated with AYI development (OR, 4.5), along with colonization intensity and repeat laparotomies.

Conclusions:

  • Deficient MBL plasma levels are independently associated with the development of AYI in secondary peritonitis patients.
  • Low MBL levels appear to contribute to the facilitation of early-stage abdominal yeast infections in this vulnerable group.

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