Abstract:
AIM:To develop an algorithm to improve the diagnosis and treatment of patients with biliary candidiasis. METHODS:We performed a prospective study of 127 patients who underwent endoscopic retrograde cholangiopancreatography, for various biliary disorders, at 3 tertiary referral centers in Germany from July 2011 through July 2012 (ClinicalTrials.gov: NCT01109550). Bile, buccal, and stool samples were collected. When indicated, endoscopic transpapillary bile duct biopsies were performed to clarify the etiology of bile duct strictures and to prove invasive fungal infections. RESULTS:Candida species were detected in 38 of the 127 bile samples (29.9%). By multivariate analysis patients' age and previous endoscopic sphincterotomy were independent risk factors for biliary candidiasis (P < 0.05). Patients with immunosuppression (P = 0.058) and recent long-term antibiotic therapy (> 7 d) (P = 0.089) tend to be at risk for biliary candidiasis. One patient was negative in mycological culture of bile fluid but invasive biliary candidiasis was diagnosed histologically. Of Candida subspecies detected, 36.7% were azole-resistant, such as C glabrata. Eight patients received anti-mycotic therapy, based on our algorithm. Of these, 3 had cancer with biliary tract involvement, 2 had secondary sclerosing cholangitis, 1 had retroperitoneal fibrosis, and 5 had septicemia. In all patients contamination was ruled out by smears of the endoscope channel. CONCLUSION:Gastroenterologists should be aware of frequent candida colonization in patients with cholangitis and biliary disorders. Our suggested algorithm facilitates the further clinical management.
journal_name
World J Gastroenteroljournal_title
World journal of gastroenterologyauthors
Lenz P,Eckelskemper F,Erichsen T,Lankisch T,Dechêne A,Lubritz G,Lenze F,Beyna T,Ullerich H,Schmedt A,Domagk Ddoi
10.3748/wjg.v20.i34.12260subject
Has Abstractpub_date
2014-09-14 00:00:00pages
12260-8issue
34eissn
1007-9327issn
2219-2840journal_volume
20pub_type
杂志文章,多中心研究abstract:AIM:To investigate the location alteration of Smad2 and Smad4 mRNAs in the liver during and after fibrogenesis in rats. METHODS:Eighty male Wistar rats weighing approximately 200 g each were used. The rat models of experimental hepatic fibrosis were established by injection with carbon tetrachloride (CCl4), normal rat...
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pub_type: 杂志文章,随机对照试验
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pub_type: 临床试验,杂志文章
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更新日期:2003-10-01 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 杂志文章,评审
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journal_title:World journal of gastroenterology
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journal_title:World journal of gastroenterology
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pub_type: 杂志文章,评审
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
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更新日期:1997-09-15 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 临床试验,杂志文章
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更新日期:2004-12-01 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
doi:10.3748/wjg.v12.i27.4369
更新日期:2006-07-21 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
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更新日期:2018-06-21 00:00:00
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更新日期:2010-01-28 00:00:00