بررسی شیوع پریتونیت قارچی در مبتلایان به سرطان بستری شده در بیمارستان امام خمینی تهران در سال90-92

Background and purpose: The prevalence of fungal peritonitis (FP) in cancer patients is rare and the information about it is limited. The aim of this study was to determine the prevalence of FP in patients with malignancy in a specific period. Material and methods: In a cross sectional study, all cancer patients with symptoms of peritonitis admitted to Imam Khomeini Hospital, Tehran for treatment were studied to identify fungal peritonitis between October 2012 and September 2013. Ascites samples from 207 patients were cultured in biphasic brain heart infusion media in order to detect fungal causative agent based on morphological characteristics and sequencing of the ITS-r DNA region of yeasts. The role of effective factors was evaluated by X2 and the t- test with 95% confidence level. Results: FP was diagnosed in 8 (3.9%) of the patients. The association of fungi with bacteria was seen in 4 cases (1.9%). Candida guilliermondii was the most common agent of FP (37.5%). Other species of Candida such as C. membranifaciens, C. carpophila, C. glabrata and C. deformans were identified with the frequency 12.5% for each case. Aspergilus fumigatus was isolated and identified from one patient (12.5%). The most frequent FP was found in genitourinary cancer in women (62.5%) and in gastrointestinal cancer in men (37.5%).There was a significant relationship between having fever, use of antibiotics during the past 6 months and the history of bacterial peritonitis (P<0.05). Conclusion: This study, like recent studies showed that Non-albicans candida species such as C. guilliermondii have an active role in nosocomial infection and FP in cancer patients. Genitourinary or gastrointestinal cancer and the outbreak of bacterial peritonitis and long-term usage of antibiotics can lead to FP. It increases the mortality in patients as well as additional complications. So, it is necessary to perform mycological diagnostic tests of ascites fluid sample in cancer patients with peritonitis sign.