Yeast Infections after Esophagectomy: A Retrospective Analysis

• Published in: Scientific reports Vol. 10; no. 1; p. 4343
• Main Authors: Heuker, Marjolein, Koser, Usma, Ott, Alewijn, Karrenbeld, Arend, van Dijl, Jan Maarten, van Dam, Gooitzen M., de Smet, Anne Marie G. A., van Oosten, Marleen
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 09-03-2020; Nature Publishing Group
• Subjects: 13/106; 692/499; 692/699/255/1672; Aged; Antifungal Agents - therapeutic use; Comorbidity; Diabetes; Diabetes mellitus; Esophageal cancer; Esophageal Neoplasms - complications; Esophageal Neoplasms - epidemiology; Esophageal Neoplasms - surgery; Esophagectomy - adverse effects; Esophagectomy - methods; Esophagus; Female; Fungal infections; Gastrointestinal surgery; Humanities and Social Sciences; Humans; Male; Malignancy; Medical prognosis; Middle Aged; Morbidity; Mortality; multidisciplinary; Mycoses - diagnosis; Mycoses - drug therapy; Mycoses - epidemiology; Mycoses - etiology; Patients; Pleural effusion; Postoperative Complications - drug therapy; Postoperative Complications - epidemiology; Postoperative Complications - microbiology; Prognosis; Retrospective Studies; Risk Factors; Science; Science (multidisciplinary); Surgery; Treatment Outcome; Yeast; Yeasts
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-020-61113-z

Esophageal malignancy is a disease with poor prognosis. Curative therapy incorporates surgery and is burdensome with high rates of infection morbidity and mortality. The role of yeast as causative organisms of post-esophagectomy infections is poorly defined. Consequently, the benefits of specific antifungal prophylactic therapy in improving patient outcome are unclear. Therefore, this study aimed at investigating the incidence of yeast infections at the University Medical Center Groningen among 565 post-esophagectomy patients between 1991 and 2017. The results show that 7.3% of the patients developed a yeast infection after esophageal resection with significantly increased incidence among patients suffering from diabetes mellitus. For patients with yeast infections, higher Acute Physiology and Chronic Health Evaluation (APACHE) II scores, more frequent intensive care unit readmissions, prolonged hospital stays and higher mortality rates were observed. One-year survival was significantly lower for patients with a yeast infection, as well as diabetes mellitus and yeast-positive pleural effusion. We conclude that the incidence of yeast infections following esophagectomy is considerable, and that patients with diabetes mellitus are at increased risk. Furthermore, yeast infections are associated with higher complication rates and mortality. These observations encourage further prospective investigations on the possible benefits of antifungal prophylactic therapy for esophagectomy patients.