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Fungal Infections in Patients With Walled-off Pancreatic Necrosis

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@article{5fb03be81eba45e78432edbaf6668746,
title = "Fungal Infections in Patients With Walled-off Pancreatic Necrosis",
abstract = "OBJECTIVES: This study aimed to evaluate the influence of fungal infection and antifungal treatment on outcome in patients with walled-off pancreatic necrosis (WON).METHODS: A retrospective description of fungal infections in a cohort of consecutive patients undergoing endoscopic, transmural drainage and necrosectomy for WON, treated in a tertiary referral center was reviewed.RESULTS: Between 2005 and 2013, fungal infection in WON was documented in 57 (46%) of 123 patients. The most common isolates at first positive culture were Candida albicans (55%) and Candida glabrata (20%). Thirty-nine (70%) patients were treated with antifungals after the first fungal finding. There was no significant difference in mortality (21% vs 13%, P = 0.517) or organ failure (34% vs 33%, P = 0.903) between the group treated with adequate antifungals after the first fungal finding compared to the group not treated or treated inadequately.The in-hospital mortality was 18% (10 patients). Concomitant fungemia was found in 6 patients, of which 3 died, as opposed to 7 with fungi in the necrosis only (50% vs 14%, P = 0.027).CONCLUSIONS: This study demonstrates a high incidence and associated high in-hospital mortality of fungal infection in WON, thus emphasizing the importance of fungal infections in WON.",
author = "Mikkel Werge and Stine Roug and Srdan Novovic and Schmidt, {Palle Nordblad} and Hansen, {Erik Feldager} and Knudsen, {Jenny Dahl}",
year = "2016",
month = nov,
doi = "10.1097/MPA.0000000000000675",
language = "English",
volume = "45",
pages = "1447--1451",
journal = "Pancreas",
issn = "0885-3177",
publisher = "Lippincott Williams & Wilkins",
number = "10",

}

RIS

TY - JOUR

T1 - Fungal Infections in Patients With Walled-off Pancreatic Necrosis

AU - Werge, Mikkel

AU - Roug, Stine

AU - Novovic, Srdan

AU - Schmidt, Palle Nordblad

AU - Hansen, Erik Feldager

AU - Knudsen, Jenny Dahl

PY - 2016/11

Y1 - 2016/11

N2 - OBJECTIVES: This study aimed to evaluate the influence of fungal infection and antifungal treatment on outcome in patients with walled-off pancreatic necrosis (WON).METHODS: A retrospective description of fungal infections in a cohort of consecutive patients undergoing endoscopic, transmural drainage and necrosectomy for WON, treated in a tertiary referral center was reviewed.RESULTS: Between 2005 and 2013, fungal infection in WON was documented in 57 (46%) of 123 patients. The most common isolates at first positive culture were Candida albicans (55%) and Candida glabrata (20%). Thirty-nine (70%) patients were treated with antifungals after the first fungal finding. There was no significant difference in mortality (21% vs 13%, P = 0.517) or organ failure (34% vs 33%, P = 0.903) between the group treated with adequate antifungals after the first fungal finding compared to the group not treated or treated inadequately.The in-hospital mortality was 18% (10 patients). Concomitant fungemia was found in 6 patients, of which 3 died, as opposed to 7 with fungi in the necrosis only (50% vs 14%, P = 0.027).CONCLUSIONS: This study demonstrates a high incidence and associated high in-hospital mortality of fungal infection in WON, thus emphasizing the importance of fungal infections in WON.

AB - OBJECTIVES: This study aimed to evaluate the influence of fungal infection and antifungal treatment on outcome in patients with walled-off pancreatic necrosis (WON).METHODS: A retrospective description of fungal infections in a cohort of consecutive patients undergoing endoscopic, transmural drainage and necrosectomy for WON, treated in a tertiary referral center was reviewed.RESULTS: Between 2005 and 2013, fungal infection in WON was documented in 57 (46%) of 123 patients. The most common isolates at first positive culture were Candida albicans (55%) and Candida glabrata (20%). Thirty-nine (70%) patients were treated with antifungals after the first fungal finding. There was no significant difference in mortality (21% vs 13%, P = 0.517) or organ failure (34% vs 33%, P = 0.903) between the group treated with adequate antifungals after the first fungal finding compared to the group not treated or treated inadequately.The in-hospital mortality was 18% (10 patients). Concomitant fungemia was found in 6 patients, of which 3 died, as opposed to 7 with fungi in the necrosis only (50% vs 14%, P = 0.027).CONCLUSIONS: This study demonstrates a high incidence and associated high in-hospital mortality of fungal infection in WON, thus emphasizing the importance of fungal infections in WON.

U2 - 10.1097/MPA.0000000000000675

DO - 10.1097/MPA.0000000000000675

M3 - Journal article

C2 - 27518465

VL - 45

SP - 1447

EP - 1451

JO - Pancreas

JF - Pancreas

SN - 0885-3177

IS - 10

ER -

ID: 48349777