ArticleBMC infectious diseases2014
Risk factors and outcome in patients with primary sclerosing cholangitis with persistent biliary candidiasis.
Article in BMC infectious diseases, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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14 citing papers in PubMed, 37 citations in OpenAlex.
- Outcomes Following Antifungal Treatment forJournal of fungi (Basel, Switzerland) · 2026Article
- Infections in primary sclerosing cholangitis and inflammatory bowel disease: a systematic review and meta-analysis.Journal of the Canadian Association of Gastroenterology · 2025Article
- Management of primary sclerosing cholangitis: Current state-of-the-art.Hepatology communications · 2024Review
- Candida spp. in Human Intestinal Health and Disease: More than a Gut Feeling.Mycopathologia · 2023Review
- Fungal infections and the fungal microbiome in hepatobiliary disorders.Journal of hepatology · 2023Review
- The intestinal and biliary microbiome in autoimmune liver disease-current evidence and concepts.Seminars in immunopathology · 2022Review
- [Bacterial hepatobiliary infections : Pathogen spectrum, antimicrobial resistance and current treatment concepts].Der Internist · 2022Review
- Molecular Pathogenesis of Cholangiocarcinoma.BMC cancer · 2019Review
- Impact of age at diagnosis on disease progression in patients with primary sclerosing cholangitis.United European gastroenterology journal · 2018Article
- Risk Factors for Multi-Drug Resistant Pathogens and Failure of Empiric First-Line Therapy in Acute Cholangitis.PloS one · 2017Article
- Impact of Microbes on the Pathogenesis of Primary Biliary Cirrhosis (PBC) and Primary Sclerosing Cholangitis (PSC).International journal of molecular sciences · 2016Review
- Observational
- Observational
- Epidemiology and Resistance Patterns of Bacterial and Fungal Colonization of Biliary Plastic Stents: A Prospective Cohort Study.PloS one · 2016Article
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCandidiasis is commonly observed in patients with primary sclerosing cholangitis (PSC), but the clinical risk factors associated with its presence have not been fully investigated. In this study, we aimed to analyse the incidence, risk factors, and transplantation-free survival in primary sclerosing cholangitis (PSC) patients with persistent biliary candidiasis.
methodsWe retrospectively analysed patients diagnosed with PSC who were admitted to our department during 2002 to 2012. One-hundred fifty patients whose bile cultures were tested for fungal species were selected, and their clinical and laboratory parameters were investigated. The results of endoscopic retrograde cholangiography (ERC) and bile cultures were analysed using chart reviews. The cases of biliary candidiasis were sub-classified as transient or persistent.
resultsThirty out of 150 (20.0%) patients had biliary candidiasis. Although all patients demonstrated comparable baseline characteristics, those with biliary candidiasis showed significantly reduced transplantation-free survival (p < 0.0001) along with a markedly elevated frequency of cholangiocarcinoma (CCA) (p = 0.04). The patients were further sub-classified according to the transient (15/30) or persistent (15/30) nature of their biliary candidiasis. A subgroup analysis showed reduced survival with a greater necessity for orthotopic liver transplantation (OLT) only in patients with persistence of Candida (p = 0.007). The survival in the patients with transient biliary candidiasis was comparable to that in candidiasis-free patients. In a multivariate regression analysis that included Mayo risk score (MRS), sex, age, dominant stenosis, inflammatory bowel disease, autoimmune hepatitis overlap syndrome, and number of times ERC was performed, biliary candidiasis was an independent risk factor for reduced survival (p = 0.008). Risk factors associated with acquisition of biliary candidiasis were age at PSC diagnosis and number of ERCs.
conclusionsThe persistence of biliary candidiasis is associated with markedly reduced transplantation-free survival in PSC patients. By contrast, actuarial survival in patients with transient biliary candidiasis approaches that for patients without any evidence of biliary candidiasis. Further studies on the treatment of persistent biliary candidiasis in patients with PSC are warranted.
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