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Colonization of the gastric juice by Candida spp. promotes surgical site infection after hepatectomy

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Abstract

Purpose

Candida spp. cause opportunistic infections in conditions of immunodeficiency. Here, we investigated the relationship between colonization of the gastric juice by Candida spp. and surgical site infection (SSI) in hepatectomy.

Methods

Consecutive hepatectomy cases between November 2019 and April 2021 were enrolled. Gastric juice samples (collected intraoperatively through a nasogastric tube) were cultured. We compared factors related to patient background, blood test findings, surgical findings, and postoperative complications between the Candida + group (positive for colonization of the gastric juice by Candida spp.) and the Candida − group (negative). In addition, we identified the factors that contribute to SSI.

Results

There were 29 and 71 patients in the Candida + and Candida − groups, respectively. The Candida + group was significantly older (average age: Candida + 74 years vs. Candida − 69 years; p = 0.02) and contained more patients negative for the hepatitis B and C virus (Candida + 93% vs. Candida − 69%; p = 0.02). SSI was significantly more common in the Candida + group (Candida + 31% vs. Candida − 9%; p = 0.01). Postoperative bile leakage and colonization of the gastric juice by Candida spp. were independent predictors of SSI.

Conclusion

Colonization of the gastric juice by Candida spp. is a risk factor for SSI after hepatectomy.

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Data availability

The protocol or datasets used during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Surgery, Shiga University of Medical Science, Seta Tsukinowa-Cho, Otsu, Shiga, 520-2192, Japan

    Hiroya Iida, Hiromitsu Maehira, Haruki Mori, Nobuhito Nitta, Takeru Maekawa, Katsushi Takebayashi, Sachiko Kaida, Toru Miyake & Masaji Tani

  2. Department of Surgery, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1010, Japan

    Masaki Kaibori

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Contributions

HI and MK designed the research and analyzed the patient data. HI, HM, HM, NN, TM, KT, SK, TM, and MT collected the data. HI drafted the manuscript. All authors have read and approved the final version of the manuscript.

Corresponding author

Correspondence to Hiroya Iida.

Ethics declarations

This prospective observational study conformed to the Clinical Research Guidelines and was approved by the ethics committee of our institution (institutional approval number: R2019-138). Written informed consent was obtained from all patients. In addition, this study was registered with UMIN-CTR (identifying number: UMIN 000048860).

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The authors declare no competing interests.

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Iida, H., Kaibori, M., Maehira, H. et al. Colonization of the gastric juice by Candida spp. promotes surgical site infection after hepatectomy. Langenbecks Arch Surg 408, 240 (2023). https://doi.org/10.1007/s00423-023-02978-2

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