{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T22:59:16Z","timestamp":1788303556755,"version":"build-2803163510"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T00:00:00Z","timestamp":1769212800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Frankfurt"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>\n                      The purpose of this study was to evaluate the outcome of patients with perforated peptic ulcer, stratified by detection of\n                      <jats:italic>Candida<\/jats:italic>\n                      spp. from peritoneal swabs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective, single-center, observational study was performed. All adult patients with perforated peptic ulcer who underwent surgical therapy were included.\n                      <jats:italic>Candida<\/jats:italic>\n                      spp. detection was defined as the result of culture incubation from peritoneal swabs at the index surgery. Its association with postoperative complications and in-hospital mortality was analyzed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 187 adult patients were included. Intraperitoneal pathogens were detected by microbiological analysis in 96 patients (61.9%).\n                      <jats:italic>Candida<\/jats:italic>\n                      spp. were detected in 62 patients (39.4%), of whom 23 (37.7%) received antifungal therapy. Patients with peritoneal detection of\n                      <jats:italic>Candida<\/jats:italic>\n                      spp. had an increased in-hospital mortality (OR 5.80, 95% CI 1.96\u201316.97,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and an increased rate of Clavien-Dindo grade III or higher complications (OR 6.08, 95% CI 2.95\u201312.54,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), suture dehiscence (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003), and longer hospital stays (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). The multivariable analysis revealed that severe complications (OR: 8.83; 95% CI: 3.19\u201324.46;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and in-hospital mortality (OR: 4.81; 95% CI: 1.16\u201319.90;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.030) were significantly more prevalent among patients with peritoneal detection of\n                      <jats:italic>Candida<\/jats:italic>\n                      spp.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Intraperitoneal presence of\n                      <jats:italic>Candida<\/jats:italic>\n                      spp. is associated with increased morbidity and mortality in patients with perforated peptic ulcer.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12893-026-03518-7","type":"journal-article","created":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T03:03:02Z","timestamp":1769223782000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Detection of Candida spp. from peritoneal swabs indicate worse outcome in patients with perforated peptic ulcer: revisiting a longstanding debate"],"prefix":"10.1186","volume":"26","author":[{"given":"Faruk","family":"Koca","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svenja","family":"Sliwinski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantin","family":"Uttinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ekaterina","family":"Petrova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrizia","family":"Malkomes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Hogardt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volkhard A. J.","family":"Kempf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tam\u00e1s","family":"Benk\u00f6","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armin","family":"Wiegering","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels","family":"Matthes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,24]]},"reference":[{"issue":"4","key":"3518_CR1","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1016\/j.amjmed.2018.12.009","volume":"132","author":"RT Kavitt","year":"2019","unstructured":"Kavitt RT, Lipowska AM, Anyane-Yeboa A, Gralnek IM. Diagnosis and treatment of peptic ulcer disease. Am J Med. 2019;132(4):447\u201356. https:\/\/doi.org\/10.1016\/j.amjmed.2018.12.009.","journal-title":"Am J Med"},{"issue":"19","key":"3518_CR2","doi-asserted-by":"publisher","first-page":"6300","DOI":"10.3390\/jcm12196300","volume":"12","author":"J Treuheit","year":"2023","unstructured":"Treuheit J, Krautz C, Weber GF, Gr\u00fctzmann R, Brunner M. Risk factors for postoperative Morbidity, suture Insufficiency, Re-Surgery and mortality in patients with gastroduodenal perforation. JCM. 2023;12(19):6300. https:\/\/doi.org\/10.3390\/jcm12196300.","journal-title":"JCM"},{"issue":"10","key":"3518_CR3","doi-asserted-by":"publisher","first-page":"1215","DOI":"10.1002\/bjs.4267","volume":"90","author":"YS Shan","year":"2003","unstructured":"Shan YS, Hsu HP, Hsieh YH, Sy ED, Lee JC, Lin PW. Significance of intraoperative peritoneal culture of fungus in perforated peptic ulcer. 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J Microbiol Immunol Infect. 2022;55(4):740\u20138. https:\/\/doi.org\/10.1016\/j.jmii.2022.03.001.","journal-title":"J Microbiol Immunol Infect"},{"issue":"8","key":"3518_CR6","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1089\/sur.2019.024","volume":"20","author":"JR Kwan","year":"2019","unstructured":"Kwan JR, Lim M, Ng F, Shelat V. Fungal isolates in peritoneal fluid culture do not impact Peri-Operative outcomes of peptic ulcer perforation. Surg Infect. 2019;20(8):619\u201324. https:\/\/doi.org\/10.1089\/sur.2019.024.","journal-title":"Surg Infect"},{"issue":"6","key":"3518_CR7","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1089\/sur.2018.058","volume":"19","author":"CB Horn","year":"2018","unstructured":"Horn CB, Coleoglou Centeno AA, Rasane RK, et al. Pre-Operative Anti-Fungal therapy does not improve outcomes in perforated peptic ulcers. 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In accordance with applicable national regulations, the requirement for informed consent was waived by the local ethics committee due to the retrospective nature of the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"81"}}