Department of Gastroenterological Surgery, Shizuoka General Hospital, Japan.
Division of Statistical Analysis, Research Support Center, Shizuoka General Hospital, Japan.
Jpn J Infect Dis. 2022 Sep 22;75(5):461-465. doi: 10.7883/yoken.JJID.2021.893. Epub 2022 Apr 28.
Intra-abdominal infections (IAIs) develop in 2.4%-26.6% of patients who underwent gastrectomy for gastric cancer and are occasionally serious. However, there are few reports on the causative organisms of IAI following upper gastrointestinal tract surgery and subsequent risk factors for Candida infections. This study aimed to identify the microorganisms that cause IAIs after gastrectomy and risk factors for Candida-related IAI. The records of patients who underwent gastrectomy for gastric cancer between January 2009 and December 2019 at Shizuoka General Hospital were retrospectively collected. Patients with IAIs of grade II or higher, as measured by the Clavien-Dindo classification, were included in the analysis. The selected patients were divided into the Candida and non-Candida groups according to the presence or absence of Candida as the causative organism. Of 1,379 patients, 56 (4.1%) were diagnosed with IAIs after gastrectomy. Fifty-two patients were included in the study based on culture analyses. A total of 111 strains and 28 bacterial species were isolated during the initial culture test. Candida constituted 7.2% of all identified pathogens. Regarding the risk factors for Candida-related IAI, a history of antimicrobial use and ≥ 4 postoperative days of IAI development were independent risk factors for Candida-related IAI.
腹腔内感染（IAI）在因胃癌行胃切除术的患者中发生率为 2.4%-26.6%，偶尔较为严重。然而，关于上消化道手术后 IAI 的病原体以及念珠菌感染的相关危险因素的报道较少。本研究旨在确定胃切除术后引起 IAI 的微生物以及与念珠菌相关 IAI 的危险因素。回顾性收集了 2009 年 1 月至 2019 年 12 月在静冈综合医院因胃癌行胃切除术的患者的记录。分析了根据 Clavien-Dindo 分级评估为 II 级或更高级别的 IAI 患者。根据是否存在念珠菌作为病原体，将选定的患者分为念珠菌和非念珠菌组。在 1379 例患者中，56 例（4.1%）在胃切除术后发生 IAI。基于培养分析，有 52 例患者纳入研究。初始培养试验共分离出 111 株和 28 种细菌。念珠菌占所有鉴定病原体的 7.2%。关于念珠菌相关 IAI 的危险因素，抗菌药物使用史和 IAI 发生后≥4 天是念珠菌相关 IAI 的独立危险因素。
