Fungal Infections in Patients with Severe Acute Pancreatitis and the Use of Prophylactic Therapy
Abstract
Data from an 8-year period for 46 patients with severe acute pancreatitis and infected pancreatic necrosis were analyzed to determine the incidence of fungal infection, to identify risk factors for the development of fungal infection, and to assess the use of early fluconazole treatment. Intraabdominal fungal infection was found in 17 (37%) of 46 patients. Candida albicans was isolated most frequently (15 patients); Candida tropicalis and Candida krusei were found in 1 patient each. Characteristics of patients with fungal infection were not different from patients without fungal infection. The difference in mortality was not statistically significant between patients with fungal infection and patients without fungal infection. Early antifungal therapy (prophylactic or preemptive antifungal therapy) was administered to 18 patients, and only 3 of them developed fungal infection. In this cohort of critically ill patients, no risk factors for fungal infection could be demonstrated, and mortality among patients who received early antifungal therapy was not different. Early treatment with fluconazole seems to prevent fungal infection in these high-risk patients.
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In SICU patients with severe acute pancreatitis, those who developed invasive candidiasis could not be differentiated from those who did not by classical parameters such as Apache II score or previous antibiotic treatment.
“in one study, surgical ICU (SICU) patients with severe acute pancreatitis who did develop invasive candidiasis could not be differentiated from those who did not become infected when evaluated according to classical parameters such as Apache II score or previous antibiotic treatment [37].”
From Management of invasive candidiasis and candidemia in adult non-neutropenic intensive care unit patients: part I. Epidemiology and diagnosis (2009) · cites this paper as [37]
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- Authors
- De Waele, J. J., Vogelaers, D., Blot, S., & Colardyn, F.
- Affiliations
- Ghent University Hospital (BE)
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2003-07-15
- Volume
- 37
- Issue
- 2
- Pages
- 208-213
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W2120036443
- Cited by
- 156
- References
- 20
- Citations by year
- 2026: 4 · 2025: 2 · 2023: 6 · 2022: 3 · 2021: 2 · 2020: 3 · 2019: 6 · 2018: 3 · 2017: 3 · 2016: 2 · 2015: 6 · 2014: 4 · 2013: 7 · 2012: 2
- FWCI
- 8.93
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Health Sciences › Medicine › Surgery › Pancreatitis Pathology and Treatment
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
- Keywords
- fungal infection, severe acute pancreatitis, infected pancreatic necrosis, Candida albicans, fluconazole, antifungal prophylaxis, preemptive antifungal therapy, risk factors, mortality, critically ill patients
- MeSH terms
- Acute Disease, Anti-Bacterial Agents, Antifungal Agents, Candida albicans, Female, Humans, Length of Stay, Male, Middle Aged, Mycoses, Pancreatitis, Fluconazole, Incidence, Survival Rate, Treatment Outcome, Chemoprevention
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