PERIOPERATIVE VARIATION IN PHAGOCYTIC-ACTIVITY AGAINST CANDIDA-ALBICANS MEASURED BY A FLOW-CYTOMETRIC ASSAY IN CARDIOVASCULAR-SURGERY PATIENTS

Candidiasis is an opportunistic fungal infection that frequently occur s following modifications of host defenses, Major surgery can be respo nsible for such alterations, and therefore it increases the risk of fu ngal infection, The purpose of this study was to evaluate the perioper ative impairment of leukocyte function in patients after cardiovascula r surgery by measuring the phagocytic activity against Candida albican s by a flow-cytometric method, The average postsurgical decrease in ph agocytosis in our patients was 11.4%, By univariate analysis, three fa ctors, all related to antibiotic therapy, were significantly associate d with an important decrease in phagocytosis: the use of antimicrobial therapy before surgery, the number of different antibiotics taken, an d the length of antibiotic treatment, The results of our study showed that the use of antibiotics in patients undergoing cardiovascular surg ery alters the normal phagocytic activity of the host immune system ag ainst C. albicans and that flow cytometry is a rapid and simple techni que that helps in early identification of patients at high risk for Ca ndida infections, The mechanisms by which surgery and antibiotics decr ease phagocytosis remain to be elucidated.