Characteristics of Infection with Candida Species inPatients with Necrotizing Pancreatitis

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Abstract
This study focuses on the relevance of Candida infection (albicans andnon-albicans) in patients with necrotizing pancreatitis.Altogether, 92 patients with infected pancreatic necrosis were reviewedfor Candida infection. All patients underwent surgicalnecrosectomy for infected pancreatic necrosis. Data from patients withCandida growth in intraoperative smears were compared tothose obtained from patients without Candida infection.There were 22 patients (24%) with Candida infection.Patients with or without Candida infection were comparableregarding age, gender, etiology, and severity scores at admission.Candida patients suffered a higher mortality (64% vs.19%, p = 0.0001) and experienced more systemiccomplications (3.2 ± 1.6 vs. 2.1 ± 1.4; p= 0.004) than patients without Candida. Preoperativeantibiotics were given significantly longer prior toCandida infection (19.0 ± 13.2 vs. 6.4 ± 10.3days; p < 0.0001). With regard to the concomitantspectrum of bacteria, solitary gram-negative infection was rare inCandida patients (5% vs. 43%, p =0.0006). The presence of Candida in patients with infectedpancreatic necrosis is associated with increased mortality. Our dataprovide evidence that application of antibiotics contributes to thedevelopment of Candida infection and to changes in thebacterial spectrum of infected necrosis with an increase in theincidence of gram-positive infection.

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