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Clin. Vaccine Immunol. doi:10.1128/CVI.00297-07
Copyright (c) 2007, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights Reserved.

Mannose-binding lectin deficiency facilitates abdominal yeast infection in patients with secondary peritonitis

Department of Surgery, Academic Medical Center, Amsterdam; Sanquin research at the Central Laboratory of the Netherlands Red Cross Blood Transfusion Service (CLB), Department of Immunopathology, Amsterdam; Sanquin research at the Central Laboratory of the Netherlands Red Cross Blood Transfusion Service (CLB), Department of Blood Cell Research, Amsterdam; Department of Clinical Virology, Academic Medical Center, Amsterdam

^* To whom correspondence should be addressed. Email: m.a.boermeester{at}amc.uva.nl.

	Abstract

Mannose-binding lectin (MBL) deficiency due to variations in the MBL gene is associated with increased susceptibility to infections. In this study the association between MBL deficiency and the occurrence of abdominal yeast infection (AYI) was examined in peritonitis patients. Eighty-eight patients with secondary peritonitis, requiring emergency laparotomy, were included. MBL genotype (wild type (WT) vs. patients with variant genotypes), MBL plasma concentrations and Candida risk factors were examined in patients with and without AYI (positive abdominal yeast cultures during (re-)laparotomy). Variant MBL genotype was found in 53% of patients with AYI and 38% of those without AYI (p=0.18). A significantly higher proportion of variant patients had an AYI during early peritonitis (during first laparotomy) compared to WT patients (39% vs. 16%, respectively; p=0.012). Patients with AYI had lower MBL levels compared to patients without AYI (0.16 (0.0-0.65) vs. 0.65 (0.19-1.95) µg/ml, p=0.007). Intensity of colonization (OR 1.1, 95% CI 1.0-1.1), MBL plasma concentrations of <0.5 µg/ml (OR 4.5, 95% CI 1.2-16.3) and number of relaparotomies (OR 1.7, 95% CI 1.0-2.8) were independently associated with AYI. In summary, deficient MBL plasma levels were independently associated with the development of AYI in patients with secondary peritonitis and seemed to facilitate early infection.