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Related Experiment Video

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Candida albicans Biofilm Development on Medically-relevant Foreign Bodies in a Mouse Subcutaneous Model Followed by Bioluminescence Imaging
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Prospective observational multicenter study to define a diagnostic algorithm for biliary candidiasis.

Philipp Lenz1, Franziska Eckelskemper1, Thomas Erichsen1

  • 1Philipp Lenz, Franziska Eckelskemper, Frank Lenze, Torsten Beyna, Hansjörg Ullerich, Andre Schmedt, Dirk Domagk, Department of Medicine B, University of Muenster, D-48149 Muenster, Germany.

World Journal of Gastroenterology
|September 19, 2014
PubMed
Summary
This summary is machine-generated.

Biliary candidiasis, a fungal infection in the bile ducts, affects nearly 30% of patients with biliary disorders. An algorithm was developed to aid in diagnosing and treating this condition, including azole-resistant Candida species.

Keywords:
Biliary candidiasisBiliary obstructionCholangitisInvasive fungal infection

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Area of Science:

  • Gastroenterology
  • Mycology
  • Infectious Diseases

Background:

  • Biliary candidiasis is a significant complication in patients with biliary disorders.
  • Accurate diagnosis and effective treatment are crucial for patient outcomes.

Purpose of the Study:

  • To develop and validate an algorithm for improving the diagnosis and treatment of biliary candidiasis.
  • To identify risk factors associated with biliary candidiasis.

Main Methods:

  • A prospective study involving 127 patients undergoing endoscopic retrograde cholangiopancreatography at three German tertiary referral centers.
  • Collection of bile, buccal, and stool samples, with endoscopic transpapillary bile duct biopsies when indicated.
  • Development of a diagnostic and treatment algorithm for biliary candidiasis.

Main Results:

  • Candida species were detected in 29.9% of bile samples.
  • Independent risk factors for biliary candidiasis included patient age and previous endoscopic sphincterotomy.
  • 36.7% of detected Candida subspecies were azole-resistant (e.g., C. glabrata).
  • The developed algorithm guided anti-mycotic therapy in eight patients with diverse underlying conditions.

Conclusions:

  • Gastroenterologists must recognize the high prevalence of Candida colonization in patients with cholangitis and biliary disorders.
  • The proposed algorithm aids in the clinical management of biliary candidiasis.
  • Awareness of azole-resistant strains is important for effective treatment.