ArticleWorld journal of hepatology2025
Incidence of spontaneous fungal peritonitis in patients with liver cirrhosis in a Mexico City population.
Article in World journal of hepatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundIndividuals with liver cirrhosis (LC) are likely to experience multiple infectious processes due to the immune dysfunction caused by the disease. Our hypothesis is that this group of patients is predisposed to fungal infections. To date, the incidence of spontaneous fungal peritonitis (SFP) has not been determined in Mexico; this endeavor is of great importance because many patients may be suffering from this condition without receiving targeted treatment, which may increase mortality.
aimTo report the incidence of SFP in patients presenting with decompensated LC with ascites.
methodsThis was a prospective, single-center, descriptive, observational and cross-sectional study where patients presenting with decompensated LC with ascites were evaluated from November 2023 to May 2024 in Mexico City. Fungal cultures of ascites were performed and the samples kept in an incubator for 10 days to 14 days, and molecular tests (the API 20 C AUX test) were used for molecular characterization.
resultsOf the 48 patients included, 54.2% were women, 77.1% had a comorbidity, 47.9% had LC secondary to metabolic dysfunction, 43.8% were classified as Child-Pugh C with a model for end-stage liver disease 3.0 median score of 22, and 10.4% were in secondary prophylaxis for spontaneous bacterial peritonitis (SBP). Only four patients had positive cultures where
conclusionThe presence of infection of fungal origin in ascites in patients presenting with cirrhosis increases short- and medium-term mortality; therefore, it is recommended that fungal culture tests are performed in those patients who visit the emergency room or experience continuous admission with acute decompensation and no bacteria identified in ascites cultures, and even more so in patients with chronic kidney disease and a history of antibiotic use as prophylaxis for SBP. Further studies are needed for the identification of clinical and biochemical data that can help to define SFP so that its presence may be assessed without the need to wait for a positive fungal culture. Thus, treatment may be initiated early in the hope of having a positive impact on the prognosis in this group of patients.
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