Vol.64 No.2 March 2016
The diagnosis, treatment and point of Candida peritonitis
Department of Infection Prevention and Control, Hyogo College of Medicine, 1-1 Mukogawacho, Nishinomiya, Hyogo, Japan
Abstract
Candida is a major cause of secondary and tertiary peritonitis. Candida peritonitis can be diagnosed when Candida is detected in the pus extracted from percutaneous drainage, or from intraperitoneal necrotic tissue under a microscope. However, if a drainage tube is in place when Candida is detected, the tube should be regarded as a colonization site. Therefore, in perforative peritonitis, not all cases are treated for Candida, even if its presence is detected. The Candida score was proposed for the early diagnosis of peritonitis suspected as having Candida. However, laboratory culture is complicated and requires a long time. In Japan, beta-D-glucan is often used for serodiagnosis. Positive Candida detection from two or more places, or a beta-D-glucan test is a standard start to empiric treatment. Although Candida albicans is the most common strain responsible for Candida peritonitis, the incidence of non-albicans Candida peritonitis is increasing. In the period from 2006 to 2013, forty patients with Candida peritonitis were treated in this study. C. albicans was the most commonly isolated organism (68.4%), followed by C. glabrata (10.5%). As initial antibiotic therapy, fosfluconazole (19/40 patients: 47.5%) and echinocandins (21/40 patients: 52.5%) were administered. Following the lack of any improvement, 21.1% of the patients who were originally on fosfluconazole went over to echinocandins. In the 33 patients in whom the therapeutic effects were evaluated, efficacy was seen in all cases.
Key word
Candida, peritonitis
Received
November 12, 2014
Accepted
November 26, 2015
Jpn. J. Chemother. 64 (2): 239-243, 2016
