Intra-Abdominal Candidiasis: The Importance of Early Source Control and Antifungal Treatment
Open accessAbstract
Intra-abdominal candidiasis (IAC) is poorly understood compared to candidemia. We described the clinical characteristics, microbiology, treatment and outcomes of IAC, and identified risk factors for mortality. We performed a retrospective study of adults diagnosed with IAC at our center in 2012-2013. Risk factors for mortality were evaluated using multivariable logistic regression. We identified 163 patients with IAC, compared to 161 with candidemia. Types of IAC were intra-abdominal abscesses (55%), secondary peritonitis (33%), primary peritonitis (5%), infected pancreatic necrosis (5%), and cholecystitis/cholangitis (3%). Eighty-three percent and 66% of secondary peritonitis and abscesses, respectively, stemmed from gastrointestinal (GI) tract sources. C. albicans (56%) and C. glabrata (24%) were the most common species. Bacterial co-infections and candidemia occurred in 67% and 6% of patients, respectively. Seventy-two percent of patients underwent an early source control intervention (within 5 days) and 72% received early antifungal treatment. 100-day mortality was 28%, and highest with primary (88%) or secondary (40%) peritonitis. Younger age, abscesses and early source control were independent predictors of survival. Younger age, abscesses and early antifungal treatment were independently associated with survival for IAC stemming from GI tract sources. Infectious diseases (ID) consultations were obtained in only 48% of patients. Consulted patients were significantly more likely to receive antifungal treatment. IAC is a common disease associated with heterogeneous manifestations, which result in poor outcomes. All patients should undergo source control interventions and receive antifungal treatment promptly. It is important for the ID community to become more engaged in treating IAC.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Intra-abdominal candidiasis is the second most common type of invasive candidiasis in intensive care units.
“Although candidemia is the most common form of IC, Candida spp. can cause infections in other sterile or deep-seated body sites, with intra-abdominal candidiasis (IAC) being the second most common type of IC in ICUs.29–31”
From Epidemiology of Invasive Candidiasis (2024) · cites this paper as [29]
The Introduction (page unavailable) calls intra-abdominal candidiasis the most common type of deep-seated candidiasis. It does not rank it second among all invasive candidiasis in intensive care units; the case counts in Clinical characteristics of IAC are for hospital admissions, not ICU patients. (LLM, conf=0.84)
Experimental — accuracy not yet measuredThe high morbidity and mortality of Candida peritonitis in developed countries has been associated with the age of patients, the use of antibiotics and corticosteroid treatment.
“The high morbidity and mortality of Candida peritonitis in developed countries has been associated with the age of patients, the use of antibiotics and corticosteroid treatment [48,49,50,51].”
From Global and Multi-National Prevalence of Fungal Diseases-Estimate Precision (2017) · cites this paper as [51]
The Treatment and outcomes section reports high mortality in patients with Candida peritonitis and identifies younger age as independently associated with survival. The Clinical characteristics section records corticosteroid treatment, and Treatment and outcomes records antibacterial treatment, but the paper does not associate either treatment with mortality; it also does not establish the claimed relationship specifically across developed countries. (LLM, conf=0.88)
Experimental — accuracy not yet measuredA lack of standardized disease definitions has made it difficult to understand and accurately capture the burden of intra-abdominal candidiasis.
“IAC covers a wide range of disease manifestations, and a lack of standardized disease definitions has made it difficult to understand and accurately capture the burden of these infections.29”
From Epidemiology of Invasive Candidiasis (2024) · cites this paper as [29]
Procalcitonin had a pooled sensitivity of 77% and specificity of 79% for sepsis in critically ill patients in a meta-analysis of 30 studies.
“In a meta-analysis of 30 studies (3,244 patients), procalcitonin had a pooled sensitivity of 77% and specificity of 79% for sepsis in critically ill patients (128).”
From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [128]
The Statistical analysis section describes a cohort analysis, and the Discussion tables report outcomes for patients with intra-abdominal candidiasis; neither addresses procalcitonin test performance. Searches for procalcitonin, the 30-study meta-analysis, and the reported sensitivity and specificity found no supporting passage in our copy. Page numbers were not available. (LLM, conf=0.77)
Experimental — accuracy not yet measuredIn a meta-analysis of 30 studies (3,244 patients), procalcitonin had a pooled sensitivity of 77% and specificity of 79% for sepsis in critically ill patients.
“In a meta-analysis of 30 studies (3,244 patients), procalcitonin had a pooled sensitivity of 77% and specificity of 79% for sepsis in critically ill patients (128).”
From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [128]
The Study design and definitions section describes a retrospective study of intra-abdominal candidiasis, and the Discussion tables report outcomes for 163 patients. Searches for procalcitonin and for the claimed meta-analysis figures found no passage reporting pooled sensitivity or specificity for sepsis. (LLM, conf=0.76)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
The citation lists haven’t been fetched yet
References 42 · Cited by 150
- Authors
- Vergidis, P., Clancy, C. J., Shields, R. K., Park, S. Y., Wildfeuer, B. N., Simmons, R. L., & Nguyen, M. H.
- Affiliations
- University of Pittsburgh (US)
- Corresponding author
- Vergidis, Pascalis
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2016-04-28
- Volume
- 11
- Issue
- 4
- Pages
- e0153247
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4849645
- OpenAlex
- W2342666693
- Semantic Scholar
- 020fc770d3f890cbe9f372dd2fbc6307591c10a8
- Cited by
- 150
- References
- 42
- Citations by year
- 2026: 10 · 2025: 16 · 2024: 13 · 2023: 18 · 2022: 9 · 2021: 19 · 2020: 17 · 2019: 15 · 2018: 15 · 2017: 14 · 2016: 4
- FWCI
- 14.68
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- public-domain
- creativecommons.org/publicdomain/zero/1.0/ (vor)
- Locations
- PLoS ONE (publishedVersion, public-domain)
- PubMed Central (publishedVersion, public-domain)
- PubMed (publishedVersion)
- D-Scholarship@Pitt (University of Pittsburgh) (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Funders
- National Institute of Allergy and Infectious Diseases (R21AI107290, K08AI114883)
- National Center for Advancing Translational Sciences (KL2TR000146)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Abdominal Surgery and Complications
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Keywords
- intra-abdominal candidiasis, candidemia, intra-abdominal abscess, secondary peritonitis, primary peritonitis, infected pancreatic necrosis, cholecystitis, cholangitis, Candida albicans, Candida glabrata, bacterial co-infection, source control, antifungal therapy, mortality risk factors, gastrointestinal infections, infectious disease consultation
- MeSH terms
- Adult, Aged, Aged, 80 and over, Antifungal Agents, Candida albicans, Candidiasis, Female, Humans, Male, Middle Aged, Peritonitis, Retrospective Studies, Risk Factors, Multivariate Analysis, Logistic Models, Abdominal Abscess, Abdominal Cavity, Candida glabrata, Gastrointestinal Tract, Young Adult, Intraabdominal Infections, Coinfection
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
