ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2026
Temporal changes in fungal epidemiology in ICU post-operative peritonitis cases.
Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2026. 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
purposeRecent changes in the mycological profile have been reported in several life-threatening infections, but no data have assessed this issue in postoperative peritonitis (POP).
methodsThis retrospective monocentric analysis (1999-2019) evaluated the temporal changes of fungi collected from POP samples in intensive care unit (ICU) patients and assessed the adequacy of antifungal therapy (AFT) and the prognosis.
resultsOverall, 1,389 microorganisms were cultured from surgical samples in 464 ICU patients, including 186 (40%) patients harbouring fungi (11 fungaemia). Growing proportions of fungi were observed over time (p < 0.01), related to increased rates of Candida albicans and C. non-albicans (p = 0.01 and p < 0.01, respectively). A significantly increased prescription of empirical AFT was observed during the study period (p < 0.0001). Adequate empirical AFT was achieved in 93/186 (50%) patients in the fungal group. Documented AFT was given in 163/174 (94%) patients in the fungal group for a median duration of 14 [9-21] days, mainly with fluconazole. The ICU and hospital mortality rates were similar in bacterial and fungal groups. However, we observed a significant increase in the duration of mechanical ventilation and ICU stay in the fungal group.
conclusionWe observed high and growing proportions of fungi in patients treated for POP associated to increasing proportions of both C. albicans and C. non-albicans. Adequate AFT was achieved in all cases with caspofungin, but fluconazole remains an acceptable option for de-escalation. Our data suggest that, in ICU patients with POP, the severity of illness, rather than adequate AFT, drives clinical outcomes.
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