• Hervé Dupont, Catherine Paugam-Burtz, Claudette Muller-Serieys, Lisiane Fierobe, Denis Chosidow, Jean-Pierre Marmuse, Jean Mantz, and Jean-Marie Desmonts.
• Department of Anesthesiology and Surgical Intensive Care Unit, University Hospital Bichat-Claude Bernard, Paris, France. herve.dupont@bch.ap-hop-paris.fr
• Arch Surg Chicago. 2002 Dec 1; 137 (12): 1341-6; discussion 1347.

BackgroundCandida peritonitis (CP) is generally considered to be a severe disease, but its impact on outcome in critically ill patients remains unknown.HypothesisThe predictive factors of mortality due to CP can be determined by study of a population of patients with CP.DesignA retrospective review of a prospective surgical intensive care unit (ICU) database of patients (January 1, 1994, through December 31, 2000).SettingUniversity hospital in Paris, France.PatientsEighty-three patients with generalized CP.Main Outcome MeasuresDemographic and microbiologic data and outcome were collected, and nonsurvivors were compared with survivors.ResultsOverall ICU mortality due to CP was 43 (52%) of 83 patients. In a stepwise multivariate logistic regression, the following 4 variables were independently associated with mortality: APACHE II (Acute Physiology and Chronic Health Evaluation II) score on admission of at least 17 (odds ratio [OR], 28.4; 95% confidence interval [CI], 5.7-142.5; P<.001), respiratory failure on admission (OR, 10.6; 95% CI, 2.2-51.2; P =.003), upper gastrointestinal tract site of peritonitis (OR, 7.7; 95% CI, 1.7-34.7; P =.007), and results of direct examination of peritoneal fluid that were positive for Candida (OR, 4.7; 95% CI, 1.2-19.7; P =.002).ConclusionsThese results confirm the severity of CP in ICU patients and emphasize the prognostic value of direct examination of peritoneal fluid for Candida in this context.

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