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Perioperative variation in phagocytic activity against Candida albicans measured by a flow-cytometric assay in
T L Tran1, P Auger, A R Marchand
1Montreal Heart Institute, Quebec, Canada.
Abstract:
Candidiasis is an opportunistic fungal infection that frequently occurs following modifications of host defenses. Major surgery can be responsible for such alterations, and therefore it increases the risk of fungal infection. The purpose of this study was to evaluate the perioperative impairment of leukocyte function in patients after cardiovascular surgery by measuring the phagocytic activity against Candida albicans by a flow-cytometric method. The average postsurgical decrease in phagocytosis in our patients was 11.4%. By univariate analysis, three factors, all related to antibiotic therapy, were significantly associated with an important decrease in phagocytosis; the use of antimicrobial therapy before surgery, the number of different antibiotics taken, and the length of antibiotic treatment. The results of our study showed that the use of antibiotics in patients undergoing cardiovascular surgery alters the normal phagocytic activity of the host immune system against C. albicans and that flow cytometry is a rapid and simple technique that helps in early identification of patients at high risk for Candida infections. The mechanisms by which surgery and antibiotics decrease phagocytosis remain to be elucidated.
Insights
Cardiovascular surgery and antibiotic use impair immune cell function, increasing Candida infection risk. Flow cytometry can identify high-risk patients early.
Area of Science:
- Immunology
- Infectious Diseases
- Surgical Science
Background:
- Candidiasis is an opportunistic fungal infection.
- Major surgery can compromise host defenses, increasing infection risk.
Purpose of the Study:
- To evaluate perioperative impairment of leukocyte function in cardiovascular surgery patients.
- To measure phagocytic activity against Candida albicans using flow cytometry.
Main Methods:
- Flow-cytometric measurement of phagocytic activity against Candida albicans.
- Univariate analysis to identify factors associated with decreased phagocytosis.
Main Results:
- Average postsurgical decrease in phagocytosis was 11.4%.
- Pre-surgery antibiotic use, number of antibiotics, and treatment duration significantly decreased phagocytosis.
- Antibiotic use alters immune response to Candida albicans.
Conclusions:
- Cardiovascular surgery and antibiotic therapy impair host immune defenses against Candida albicans.
- Flow cytometry is a rapid tool for identifying patients at high risk for Candida infections.
- Mechanisms of surgery- and antibiotic-induced phagocytosis impairment require further investigation.