Positive peritoneal fluid fungal cultures in postoperative peritonitis after bariatric surgery

Area of Science:

• Surgical Complications
• Infectious Diseases
• Critical Care Medicine

Background:

• Postoperative peritonitis (POP) is a frequent complication following bariatric surgery (BS).
• The role of fungal infections, particularly Candida, in POP requires further investigation.
• Intensive care unit (ICU) management of POP necessitates understanding specific etiological factors.

Purpose of the Study:

• To evaluate the significance of positive fungal cultures in patients with POP after BS admitted to the ICU.
• To compare clinical features and outcomes between Candida-positive and Candida-negative POP patients.
• To identify risk factors associated with mortality in this patient cohort.

Main Methods:

• Retrospective analysis of patients with POP following BS admitted to the ICU.
• Comparison of clinical data and microbiological findings between patients with and without Candida infection.
• Identification of Candida species and assessment of antifungal resistance, including fluconazole resistance in Candida glabrata.

Main Results:

• Candida was isolated in 41% of POP cases, frequently in late-onset peritonitis.
• Candida infections were often associated with multidrug-resistant bacteria.
• Mortality in the ICU was 19.6%, with diabetes and superobesity identified as risk factors.

Conclusions:

• Candida infections are prevalent in postoperative peritonitis after bariatric surgery.
• Fluconazole-resistant Candida strains, such as Candida glabrata, were observed.
• Empirical use of broad-spectrum antifungal agents is encouraged for managing POP in BS patients.