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

World Journal of Gastroenterology 2014年第34期20卷 12260-12268页

作者： Philipp Lenz Franziska Eckelskemper Thomas Erichsen Tim Lankisch Alexander Dechêne Gabriele Lubritz Frank Lenze Torsten Beyna hansjorg ullerich Andre Schmedt Dirk Domagk Department of Medicine B University of MuensterD-48149 MuensterGermany Department of Gastroenterology Hepatology and EndocrinologyHannover Medical School30625 HannoverGermany Department of Gastroenterology and Hepatology University Hospital Essen45147 EssenGermany Institute of Medical Microbiology University Hospital MuensterD-48149 MuensterGermany

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.

关键词： Cholangitis Biliary candidiasis Invasive fungal infection Biliary obstruction

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