Immunomonitoring: To analyse monocyte HLA-DR expression (mHLA-DR) and CD4+ T lymphocyte count (CD4) in both group
Study summary
Intra-abdominal candidiasis (IAC) is a frequent and severe fungal infection in critically ill patients, often diagnosed late. Its pathophysiology remains unclear, particularly regarding why some patients develop invasive infection while others only show benign colonization. A potential explanation lies in the state of innate immunity. Monocyte HLA-DR expression, a recognized marker of immune suppression in critical care, may be transiently but profoundly reduced in non-immunocompromised patients who go on to develop IAC. This observational study aims to evaluate whether patients with IAC have greater innate immune dysfunction-assessed by HLA-DR expression-compared to those with severe bacterial intra-abdominal infections. The goal is to better understand the immune mechanisms involved and improve early risk stratification for IAC.
Eligibility
Sex
ALL
Min age
18 Years
Max age
—
Healthy volunteers
No
Inclusion Criteria:
* Adult patient (≥ 18 years old)
* Patient admitted to the ICU or intermediate care unit for a severe intra-abdominal infection requiring urgent abdominal surgery
* Presence of at least one risk factor for intra-abdominal candidiasis:
* Abdominal surgery within the last 7 days
* Supramesocolic gastrointestinal perforation
* Healthcare-associated intra-abdominal infection
* Community-acquired intra-abdominal infection in an immunocompromised patient\*
* Intra-abdominal infection complicated by septic shock
* Broad-spectrum antibiotic exposure within 72 hours prior to surgery
* And/or a Peritonitis Score ≥ 3 out of 4
* Patient affiliated with or benefiting from a national health insurance system
* Patient who has received full information about the clinical study
Exclusion Criteria:
* Radiologically guided drainage without surgery
* Infected acute pancreatitis
* Limitation or withdrawal of life-sustaining treatments
* Moribund patient with an expected life expectancy \< 48 hours
* Woman of childbearing potential without effective contraception
* Refusal to participate in the study
Primary outcome measure(s)
Correlation Between percentage of Monocyte HLA-DR Expression and the Occurrence of Intra-abdominal Candidiasis — Within 7 days after abdominal surgery Assessment of the relationship between monocyte HLA-DR expression levels and the development of intra-abdominal candidiasis in critically ill patients with severe intra-abdominal infection.
Trial sites (1)
Facility
City
Region
Status
CHRU de NANCY
Vandœuvre-lès-Nancy
France
Recruiting
More Central Hospital, Nancy, France trials in France
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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