Polymorphisms in tumor necrosis factor-α increase susceptibility to intra-abdominal Candida infection in high-risk surgical ICU patients*.

Details

Serval ID
serval:BIB_9E94BE692A2A
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Polymorphisms in tumor necrosis factor-α increase susceptibility to intra-abdominal Candida infection in high-risk surgical ICU patients*.
Journal
Critical Care Medicine
Author(s)
Wójtowicz A., Tissot F., Lamoth F., Orasch C., Eggimann P., Siegemund M., Zimmerli S., Flueckiger U.M., Bille J., Calandra T., Marchetti O., Bochud P.Y., Fungal Infection Network of Switzerland
Contributor(s)
Fungal Infection Network of Switzerland
ISSN
1530-0293 (Electronic)
ISSN-L
0090-3493
Publication state
Published
Issued date
2014
Peer-reviewed
Oui
Volume
42
Number
4
Pages
e304-e308
Language
english
Notes
Publication types: Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't Publication Status: ppublishPDF : Online brief reports
Abstract
OBJECTIVES: To evaluate the influence of genetic polymorphisms on the susceptibility to Candida colonization and intra-abdominal candidiasis, a blood culture-negative life-threatening infection in high-risk surgical ICU patients.
DESIGN: Prospective observational cohort study.
SETTING: Surgical ICUs from two University hospitals of the Fungal Infection Network of Switzerland.
PATIENTS: Eighty-nine patients at high risk for intra-abdominal candidiasis (68 with recurrent gastrointestinal perforation and 21 with acute necrotizing pancreatitis).
MEASUREMENTS AND MAIN RESULTS: Eighteen single-nucleotide polymorphisms in 16 genes previously associated with development of fungal infections were analyzed from patient's DNA by using an Illumina Veracode genotyping platform. Candida colonization was defined by recovery of Candida species from at least one nonsterile site by twice weekly monitoring of cultures from oropharynx, stools, urine, skin, and/or respiratory tract. A corrected colonization index greater than or equal to 0.4 defined "heavy" colonization. Intra-abdominal candidiasis was defined by the presence of clinical symptoms and signs of peritonitis or intra-abdominal abscess and isolation of Candida species either in pure or mixed culture from intraoperatively collected abdominal samples. Single-nucleotide polymorphisms in three innate immune genes were associated with development of a Candida corrected colonization index greater than or equal to 0.4 (Toll-like receptor rs4986790, hazard ratio = 3.39; 95% CI, 1.45-7.93; p = 0.005) or occurrence of intra-abdominal candidiasis (tumor necrosis factor-α rs1800629, hazard ratio = 4.31; 95% CI, 1.85-10.1; p= 0.0007; β-defensin 1 rs1800972, hazard ratio = 3.21; 95% CI, 1.36-7.59; p = 0.008).
CONCLUSION: We report a strong association between the promoter rs1800629 single-nucleotide polymorphism in tumor necrosis factor-α and an increased susceptibility to intra-abdominal candidiasis in a homogenous prospective cohort of high-risk surgical ICU patients. This finding highlights the relevance of the tumor necrosis factor-α functional polymorphism in immune response to fungal pathogens. Immunogenetic profiling in patients at clinical high risk followed by targeted antifungal interventions may improve the prevention or preemptive management of this life-threatening infection.
Keywords
Adult, Age Factors, Aged, Aged, 80 and over, Candidiasis/epidemiology, Female, Genotype, Humans, Intensive Care Units, Intraabdominal Infections/epidemiology, Male, Middle Aged, Polymorphism, Single Nucleotide, Postoperative Complications/epidemiology, Prospective Studies, Sex Factors, Switzerland, Tumor Necrosis Factor-alpha/genetics
Pubmed
Web of science
Create date
16/05/2014 16:52
Last modification date
20/08/2019 15:04
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