González-González Gustavo Adolfo, Nocua-Báez Laura Cristina, Melendez-Rhenals Sugeich, Reyes Patricia, Cortés Jorge Alberto
Department of Internal Medicine, Faculty of Medicine, Universidad Nacional de Colombia, Bogotá 111321, Colombia.
Infectious Diseases Department, Hospital Universitario Nacional de Colombia, Office of Clinical Research, Campus Santa Rosa, Bogotá 111321, Colombia.
J Fungi (Basel). 2025 Jul 29;11(8):562. doi: 10.3390/jof11080562.
: Peritonitis resulting from spp. is common among critically ill patients and has been associated with adverse clinical outcomes. This study aimed to determine the effects of isolates of species in patients with peritonitis on in-hospital mortality, general hospital stay, and intensive care unit (ICU) stays. : This retrospective cohort study was conducted in two highly complex hospitals in Bogotá, Colombia, specifically by reference to patients who were hospitalized in the ICU between 2016 and 2022 with a clinical and microbiological diagnosis of peritonitis. For the analysis conducted for this research, two groups were established: patients with isolates of spp. in the peritoneum and patients who had at least one bacterial microorganism in the culture. Multivariate logistic regression models and counting models featuring different mortality outcomes, different lengths of stay in the ICU, and different lengths of stay in the hospital were generated to evaluate the effect of the presence of spp. and to account for potentially confounding variables. : A total of 373 patients, including 83 with spp. and 290 with a bacterial etiology, were identified. Among the former group of patients, the most frequently identified species were (50, 60.2%), (18, 21.7%), and (7, 8.4%), whereas among the latter group, (186, 48.5%), (110, 29.8%), and (63, 16.9%) were most frequent. The 30-day mortality rate among patients with peritonitis and isolates was 36.1%, and the corresponding rate among patients in the bacterial peritonitis group was 31.4% ( = 0.071). After adjustments were made to account for covariates, no significant differences were observed in mortality at 30 days (OR 0.75, 95% CI 0.20-1.18), length of hospital stay (iRR 1.11, 95% CI 0.90-1.40), or length of stay in the ICU (iRR 1.11, 95% CI 0.39) with respect to patients with peritonitis without fungal isolates. The Simplified Acute Physiology Score (SAPS2) (OR 1.04, 95% CI 1.03-1.06), World Society of Emergency Surgery (WSES) score (OR 1.11, (1.03-1.19), previous use of antifungals (OR 2.33, 1.21-4.52), and connective tissue disease (OR 3.71, 95% CI 1.30-10.99) were associated with 30-day mortality. : The isolation of species in peritoneal fluid from critically ill patients with peritonitis was not significantly associated with in-hospital mortality, length of hospital stay, or length of ICU stay after adjustments were made to account for other variables.
由[具体菌种]引起的腹膜炎在重症患者中很常见，且与不良临床结局相关。本研究旨在确定腹膜炎患者中[具体菌种]分离株对住院死亡率、总住院时间和重症监护病房（ICU）住院时间的影响。：本回顾性队列研究在哥伦比亚波哥大的两家高度复杂的医院进行，具体针对2016年至2022年期间在ICU住院且临床和微生物学诊断为腹膜炎的患者。对于本研究进行的分析，设立了两组：腹膜中有[具体菌种]分离株的患者和培养中有至少一种细菌微生物的患者。生成了多变量逻辑回归模型和计数模型，这些模型具有不同的死亡率结局、不同的ICU住院时长和不同的住院时长，以评估[具体菌种]的存在所产生的影响，并考虑潜在的混杂变量。：共确定了373例患者，其中83例有[具体菌种]，290例有细菌病因。在前一组患者中，最常鉴定出的菌种是[菌种1]（50例，60.2%）、[菌种2]（18例，21.7%）和[菌种3]（7例，8.4%），而后一组中最常见的是[细菌1]（186例，48.5%）、[细菌2]（110例，29.8%）和[细菌3]（63例，16.9%）。腹膜炎合并[具体菌种]分离株患者的30天死亡率为36.1%，细菌性腹膜炎组患者的相应死亡率为31.4%（P = 0.071）。在对协变量进行调整后，未观察到30天死亡率（比值比0.75，95%置信区间0.20 - 1.18）、住院时间（发病率比1.11，95%置信区间0.90 - 1.40）或ICU住院时间（发病率比1.11，95%置信区间0.39）与无真菌分离株的腹膜炎患者有显著差异。简化急性生理学评分（SAPS2）（比值比1.04，95%置信区间1.03 - 1.06）、世界急诊外科学会（WSES）评分（比值比1.11，（1.03 - 1.19）、先前使用抗真菌药物（比值比2.33，1.21 - 4.52）和结缔组织病（比值比3.71，95%置信区间1.30 - 10.99）与30天死亡率相关。：在对其他变量进行调整后，重症腹膜炎患者腹膜液中[具体菌种]的分离与住院死亡率、住院时间或ICU住院时间无显著关联。
