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

Abstract

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 who were 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.