Department of Surgery, Shiga University of Medical Science, Seta Tsukinowa-Cho, Otsu, Shiga, 520-2192, Japan.
Department of Surgery, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1010, Japan.
Langenbecks Arch Surg. 2023 Jun 20;408(1):240. doi: 10.1007/s00423-023-02978-2.
Candida spp. cause opportunistic infections in conditions of immunodeficiency. Here, we investigated the relationship between colonization of the gastric juice by Candida spp. and surgical site infection (SSI) in hepatectomy.
Consecutive hepatectomy cases between November 2019 and April 2021 were enrolled. Gastric juice samples (collected intraoperatively through a nasogastric tube) were cultured. We compared factors related to patient background, blood test findings, surgical findings, and postoperative complications between the Candida + group (positive for colonization of the gastric juice by Candida spp.) and the Candida - group (negative). In addition, we identified the factors that contribute to SSI.
There were 29 and 71 patients in the Candida + and Candida - groups, respectively. The Candida + group was significantly older (average age: Candida + 74 years vs. Candida - 69 years; p = 0.02) and contained more patients negative for the hepatitis B and C virus (Candida + 93% vs. Candida - 69%; p = 0.02). SSI was significantly more common in the Candida + group (Candida + 31% vs. Candida - 9%; p = 0.01). Postoperative bile leakage and colonization of the gastric juice by Candida spp. were independent predictors of SSI.
Colonization of the gastric juice by Candida spp. is a risk factor for SSI after hepatectomy.
假丝酵母菌属在免疫功能低下的情况下引起机会性感染。在此，我们研究了假丝酵母菌属在肝切除术后胃内容物定植与手术部位感染（SSI）之间的关系。
连续纳入 2019 年 11 月至 2021 年 4 月期间行肝切除术的病例。术中通过鼻胃管采集胃内容物样本进行培养。我们比较了假丝酵母菌属定植阳性（Candida+组）和定植阴性（Candida-组）患者的背景、血液检查结果、手术发现和术后并发症等相关因素。此外，我们还确定了导致 SSI 的因素。
Candida+组和 Candida-组分别有 29 例和 71 例患者。Candida+组年龄明显较大（平均年龄：Candida+组 74 岁 vs. Candida-组 69 岁；p=0.02），乙型肝炎和丙型肝炎病毒阴性的患者更多（Candida+组 93% vs. Candida-组 69%；p=0.02）。Candida+组 SSI 的发生率明显更高（Candida+组 31% vs. Candida-组 9%；p=0.01）。术后胆汁漏和胃内容物假丝酵母菌属定植是 SSI 的独立预测因素。
假丝酵母菌属胃内容物定植是肝切除术后 SSI 的危险因素。
