Prospective observational multicenter study to define a diagnostic algorithm for biliary candidiasis

作     者：Philipp Lenz Franziska Eckelskemper Thomas Erichsen Tim Lankisch Alexander Dechêne Gabriele Lubritz Frank Lenze Torsten Beyna Hansjorg Ullerich Andre Schmedt Dirk Domagk 

作者机构：Department of Medicine BUniversity of MuensterD-48149 MuensterGermany Department of GastroenterologyHepatology and EndocrinologyHannover Medical School30625 HannoverGermany Department of Gastroenterology and HepatologyUniversity Hospital Essen45147 EssenGermany Institute of Medical MicrobiologyUniversity Hospital MuensterD-48149 MuensterGermany 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2014年第20卷第34期

页      面：12260-12268页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：Supported by An Investigator-Initiated Studies Program of MSD Sharp and Dohme GmbH a research fellowship(to Lenz P)from the Faculty of Medicine,Westfaelische Wilhelms Universitat Muenster 

主　　题：Cholangitis Biliary candidiasis Invasive fungal infection Biliary obstruction 

摘      要：AIM:To develop an algorithm to improve the diagnosis and treatment of patients with biliary ***:We performed a prospective study of 127patients who underwent endoscopic retrograde cholangiopancreatography,for various biliary disorders,at 3 tertiary referral centers in Germany from July 2011through July 2012(***:NCT01109550).Bile,buccal,and stool samples were *** indicated,endoscopic transpapillary bile duct biopsies were performed to clarify the etiology of bile duct strictures and to prove invasive fungal ***: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(P7 d)(P=0.089)tend to be at risk for biliary *** patient was negative in mycological culture of bile fluid but invasive biliary candidiasis was diagnosed *** Candida subspecies detected,36.7%were azole-resistant,such as C *** patients received anti-mycotic therapy,based on our *** these,3 had cancer with biliary tract involvement,2had secondary sclerosing cholangitis,1 had retroperitoneal fibrosis,and 5 had *** all patients contamination was ruled out by smears of the endoscope ***:Gastroenterologists should be aware of frequent candida colonization in patients with cholangitis and biliary *** suggested algorithm facilitates the further clinical management.