PCR-detected fungal infection is associated with fatal outcomes in cirrhotic patients with spontaneous peritonitis
| Autor: | Ahmed Ibrahim, Laila A. Eissa, Nawal S. Gouda, Shaimaa R. Elkhateeb, Rokiah Anwar |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Cirrhosis medicine.drug_class 030106 microbiology Antibiotics Biomedical Engineering Peritonitis Drug resistance Biochemistry Genetics and Molecular Biology (miscellaneous) Gastroenterology 03 medical and health sciences 0302 clinical medicine Spontaneous bacterial peritonitis Structural Biology Internal medicine White blood cell medicine Resistant Spontaneous Peritonitis lcsh:QH301-705.5 Serum-ascites albumin gradient lcsh:R5-920 business.industry Incidence (epidemiology) medicine.disease Polymerase chain reaction Surgery medicine.anatomical_structure ITS1/fungal DNA lcsh:Biology (General) 030211 gastroenterology & hepatology Spontaneous fungal peritonitis (SFP) Spontaneous Peritonitis (SP) lcsh:Medicine (General) business |
| Zdroj: | Egyptian Journal of Basic and Applied Sciences, Vol 4, Iss 1, Pp 42-46 (2017) |
| ISSN: | 2314-808X |
| Popis: | Background & aims The rate of mortality from Spontaneous Peritonitis (SP) in cirrhotic patients is still high despite the development of new antibiotic treatments and intensive hospital care. The coexistence of spontaneous fungal peritonitis (SFP) is almost entirely ignored health problem, because it is difficult to be diagnosed at an early stage by conventional culture-based methods. Therefore, this study was designed to employ PCR-based method in evaluating the prevalence of fungal infection in cirrhotic patients with peritonitis who failed to respond to the recommended therapy and to determine its association with in-hospital mortality. Subjects and Methods A total of 80 cirrhotic patients admitted to the hospital with ascitis (June-2013 to April-2015) were followed in this study. Results During hospitalization, 23 (42%) of patients had died although they received guideline-driven treatment. The demographics, clinical, hematological, and biochemical data were similar in both mortality and survival groups. However, the incidence of fungus infection was the only significantly elevated parameter in the mortality group than in the survival group (7/23;30% vs.0/32;0%, P = 0.0012). This fungal infection was significantly associated with SP drug resistance development (P = 0.007). Intriguingly, all the cases of fungal infection were detected by PCR-based method while culture-based diagnosis was able to detect the fungal infection in only 4 of these cases indicating a diagnostic sensitivity of 57%. Conclusion Our results reflect a strong association between SFP and in-hospital mortality in cirrhotic patients with SP that may offer a coherent explanation for the antibiotic treatment failure in such patients. Prompt PCR-detection and antifungal coverage is warranted in these cases. |
| Databáze: | OpenAIRE |
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