Candiduria in Those over 85 Years Old: A Retrospective Study of 73 Patients

Fraisse, T.; Crouzet, Julien; Lachaud, Laurence; Durand, Anne; Charachon, Sylvie; Lavigne, Jean Philippe; Sotto, Albert

doi:10.2169/internalmedicine.50.5560

Cited by 18 publications

(10 citation statements)

References 24 publications

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“…The incidence was 2.51% in patients older than 60 years and 3.41% in patients younger than 1 year, significantly higher than the overall incidence rate (1.61%). Older age is a classical risk factor for candiduria (Fraisse et al, 2011). In healthy babies, the urinary tract is generally considered to be clean and without candida colonization, while in NICU patients, particularly premature infants, candiduria and candidemia were not rare (Kelly, Benjamin Jr & Smith, 2015; Swanson, Gurka & Kaufman, 2014).…”

Section: Discussionmentioning

confidence: 99%

Candiduria in hospitalized patients: an investigation with the Sysmex UF-1000i urine analyzer

He¹,

Li²,

Wang³

et al. 2019

PeerJ

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Background Candiduria is common in hospitalized patients. Its management is limited because of inadequate understanding. Previous epidemiological studies based on culture assay have been limited to small study populations. Therefore, data collected by automated systems from a large target population are necessary for more comprehensive understanding of candiduria in hospitalized patients. Methods To determine the performance of the Sysmex UF-1000i in detecting candiduria, a cross-sectional study was designed and conducted. A total of 203 yeast-like cell (YLC)-positive and 127 negative samples were randomly chosen and subjected to microbiologic analysis. The receiver operating characteristic curve (ROC) was used to evaluate the ability of YLC counts as measured by the Sysmex UF1000i to predict candiduria. Urinalysis data from 31,648 hospitalized patients were retrospectively investigated, and statistical analysis was applied to the data collected. Results Using a cutoff value of 84.6 YLCs/µL, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the yeast like cell (YLC) counts to predict candiduria were 61.7%, 84.1%, 88.6% and 66.3%, respectively. C. glabrata (33.6%) and C. tropicalis (31.4%) were more prevalent than C. albicans (24.3%) in the present study. Of the investigated hospitalized patients, 509 (1.61%) were considered candiduria-positive. Age, gender and basic condition were associated with candiduria in hospitalized patients. In the ICU setting, urinary catheterization appeared to be the only independent risk factor contributing to candiduria according to our investigation. Although antibiotic therapy has been reported to be a very important risk factor, we could not confirm its significance in ICU candiduria patients because of excessive antibiotic usage in our hospital. Conclusions The YLC measured by Sysmex UF-1000i is a practical and convenient tool for clinical candiduria screening prior to microbiologic culture. Candiduria is common in hospitalized patients, and its incidence varies according to age, gender and the wards where it is isolated. Candiduria had no direct connection with mortality but might be considered a marker of seriously ill patients who need particular attention in the clinic.

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Section: Discussionmentioning

confidence: 99%

Candiduria in hospitalized patients: an investigation with the Sysmex UF-1000i urine analyzer

He¹,

Li²,

Wang³

et al. 2019

PeerJ

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“…It corresponds to more predisposing factors including, long stays at hospitals (especially in ICU and NICU), urinary indwelling catheters, abnormality in urinary tract, immunosuppressive therapy in immunocompromised patients, renal transplantation, broad spectrum antibacterial therapy and hemodialysis ( 6 , 14 - 17 ). In addition, candiduria was commonly found in elderly people aged 85 years and older ( 18 ).…”

Section: Discussionmentioning

confidence: 99%

The Susceptibility Patterns of Candida Species Isolated From Urine Samples to Posaconazole and Caspofungin

Mahmoudabadi

Rezaei‐Matehkolaei

Ghanavati

2015

Jundishapur J Microbiol

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Background:Candiduria is a rising condition among hospitalized patients and Candida albicans is the most common recovered agent. However, non-albicans Candida species (NACs) such as C. glabrata, C. krusei, C. parapsilosis, and C. tropicalis are also important. Although most Candida species especially C. albicans are sensitive to routinely used antifungals, an increasing trend in resistance has been observed among NACs.Objectives:The aim of the present study was to detect the susceptibility of Candida strains recovered from candiduria in hospitalized patients against posaconazole and caspofungin.Materials and Methods:A total of 120 urine samples were taken from patients hospitalized in Intensive Care Units (ICUs) (65) and urology (55) wards. All recovered yeasts were differentiated by using CHROMagar Candida medium and routine tests for identification of Candida species. Minimal inhibitory concentrations (MICs) of all isolates towards posaconazole and caspofungin were determined using the microdilution method with serial dilutions from 8 to 0.0625 µg/mL (posaconazole) and 4 to 0.03125 µg/ mL (caspofungin).Results:In total, 41.7% of urine samples were positive for Candida isolation, including C. albicans (46%), C. glabrata (24%), C. tropicalis (16%) and C. krusei (14%). The MIC of caspofungin for 90% of the tested isolates was lower than 2 µg/mL. Furthermore, 94% of the tested isolates were inhibited by posaconazole at lower than 2 µg/mL after 24 hours, whereas 6% of isolates had MICs of more than 4 µg/mL.Conclusions:This study demonstrates the importance of Candida species in urine samples from hospitalized patients in ICUs and urology wards. It showed that both tested antifungals had excellent effects on different species of Candida, however the strains from ICUs were found to be more sensitive to caspofungin than posaconazole.

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“…Nosocomial candiduria has even a higher prevalence ranging from 10 to 89% (7). Apart from uncontrolled diabetes, female gender, old age, presence of indwelling urinary catheter, prior use of antibiotics, and acidic urine pH are other known risk factors for urinary candida colonization (6, 7, 16–21).…”

Section: Discussion and Review Of Literaturementioning

confidence: 99%

Candidemia Following Ureteric Stent Placement in a Patient With Type 2 Diabetes Treated With Canagliflozin

et al. 2019

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A 38-year-old female patient with well-controlled type 2 diabetes mellitus treated with canagliflozin underwent ureteral stent placement for obstructive renal calculi. Ten days following ureteroscopy and ureteral stenting, she developed fevers and blood cultures grew Candida glabrata (C. glabrata). The patient was successfully treated with an extended course of broad-spectrum antibiotics and antifungal agents. The clinical presentation of candidemia is indistinguishable from bacteremia resulting in delay in diagnosis and treatment. Candiduria is commonly seen in patients with type 2 diabetes, however it rarely leads to candidemia in an otherwise healthy person following a relatively simple urologic procedure. Sodium-glucose co-transporter 2 (SGLT-2) inhibitors act by its glycosuric effect and further increases the risk of genitourinary candida infection. Urologic procedures may lead to bloodstream entry of the genitourinary fungal organisms and result in life-threatening fungemia. Our case emphasizes the importance of awareness of the increased risk of potentially life threatening fungemia in patients using SGLT-2 inhibitors to avoid delay in diagnosis and treatment.

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Candiduria in Those over 85 Years Old: A Retrospective Study of 73 Patients

Cited by 18 publications

References 24 publications

Candiduria in hospitalized patients: an investigation with the Sysmex UF-1000i urine analyzer

Candiduria in hospitalized patients: an investigation with the Sysmex UF-1000i urine analyzer

The Susceptibility Patterns of Candida Species Isolated From Urine Samples to Posaconazole and Caspofungin

Candidemia Following Ureteric Stent Placement in a Patient With Type 2 Diabetes Treated With Canagliflozin

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