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Author Spotlight: Advancing Research on Candida albicans Biofilm-Associated Prosthetic Joint Infections
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Fungal versus non-fungal supra-inguinal prosthetic vascular graft infections: A cohort study

Baptiste Monnier1, Thibault Couture2, Agnès Dechartres3

  • 1Département d'Anesthésie-Réanimation, Hôpital Pitié-Salpétrière, AP-HP, France.

Infectious Diseases Now
|September 30, 2023
PubMed
Abstract

Insights

Fungal prosthetic vascular graft infections (PVGI) are rare but linked to higher mortality. Prosthetic-digestive fistulas and prolonged antibiotic use are key risk factors for fungal PVGI.

Area of Science:

  • Vascular surgery
  • Infectious diseases
  • Mycology

Background:

  • Fungal prosthetic vascular graft infections (PVGI) are uncommon, primarily affecting supra-inguinal grafts.
  • Existing guidelines lack comprehensive data on risk factors and outcomes for this specific patient group.

Purpose of the Study:

  • To compare fungal and non-fungal supra-inguinal PVGI.
  • Identify specific risk factors and evaluate outcomes for fungal PVGI.
  • Inform clinical management and guidelines.

Main Methods:

  • Retrospective cohort study at a single center (Pitié-Salpêtrière Hospital, Paris).
  • Inclusion of patients treated for supra-inguinal PVGI between January 2009 and February 2021.
  • Comparison of preoperative, intraoperative, and postoperative data between fungal and non-fungal PVGI groups.

Main Results:

  • Out of 148 supra-inguinal PVGI cases, 32 were fungal and 116 non-fungal.
  • Independent risk factors for fungal PVGI included prostheto-digestive fistula (OR 5.98) and preoperative antibiotics ≥7 days (OR 2.87).
  • 180-day mortality was significantly higher in fungal PVGI (38%) versus non-fungal (16%), particularly with prostheto-digestive fistulas.

Conclusions:

  • Prostheto-digestive fistula is a strong predictor of fungal PVGI.
  • The study suggests considering antifungal agents in patients with PVGI and prostheto-digestive fistulas.
  • Enhanced vigilance and targeted antifungal therapy may improve outcomes for high-risk fungal PVGI cases.
Keywords:
CandidaMortalityProstheto-digestive fistulaRisk FactorsVascular graft infections

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