Investigation of the possible association between nosocomial candiduria and candidaemia

Binelli, C.; Moretti, M.L.; Assis, Rosenilda S.; Sauaia, Naim; Menezes, Paulo Rossi; Ribeiro, Érica Del Peloso; Geiger, Débora; Mikami, Yuzuru; Miyaji, Makoto; Oliveira, Marina Simões; Barone, Antonio; Levin, Anna S.

doi:10.1111/j.1469-0691.2006.01435.x

Cited by 69 publications

(46 citation statements)

References 37 publications

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“…These data are in accordance with other Brazilian studies [42][43][44][45] . In our study the frequency of UTI/1,000 urinary catheter (UC) days was greater than in studies realized in developing countries 46 , and although these infections are responsible for almost 40% of all NI, they continue to be unrepresentative in Brazilian hospitals, considering that the majority of them (80%) are associated with the use of urinary catheters 47,48 .…”

supporting

confidence: 93%

Nosocomial infections in a pediatric intensive care unit of a developing country: NHSN surveillance

Porto

Mantese

Arantes

et al. 2012

Rev. Soc. Bras. Med. Trop.

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Introduction: This study aimed to determine the epidemiology of the three most common nosocomial infections (NI), namely, sepsis, pneumonia, and urinary tract infection (UTI), in a pediatric intensive care unit (PICU) in a developing country and to define the risk factors associated with NI. Methods: We performed a prospective study on the incidence of NI in a single PICU, between August 2009 and August 2010. Active surveillance by National Healthcare Safety Network (NHSN) was conducted in the unit and in a case control approach, children with NI (cases) were compared with a matched controls without NI. Results: We analyzed 172 patients; 22.1% had NI, 71.1% of whom acquired it in the unit. The incidence densities of sepsis, pneumonia, and UTI per 1,000 patients/day were 17.9, 11.4, and 4.3, respectively. The most common agents in sepsis were Enterococcus faecalis and Escherichia coli (18% each); Staphylococcus epidermidis was isolated in 13% of cases. In pneumonias Staphylococcus aureus was the most common cause (3.2%), and in UTI the most frequent agents were yeasts (33.3%). The presence of NI was associated with a long period of hospitalization, use of invasive devices (central venous catheter, nasogastric tube), and use of antibiotics. The last two were independent factors for NI. Conclusions: The incidence of NI acquired in this unit was high and was associated with extrinsic factors. Keywords: Nosocomial infections. Pediatric ICU. Surveillance system. RESUMO Introdução:O objetivo deste estudo foi determinar a epidemiologia das três infecções hospitalares (IH) mais comuns -sepse, pneumonia e infecção do trato urinário (ITU) -em uma unidade de terapia intensiva pediátrica (UTIP) de um país em desenvolvimento e definir os fatores de risco associados com IH. Métodos: Nós desenvolvemos um estudo prospectivo de incidência de IH em uma única UTIP, entre agosto/2009 e agosto/2010. Foi conduzida uma vigilância ativa pelo National Healthcare Safety Network (NHSN) na Unidade e as crianças com IH (casos) foram comparadas com um grupo (controles) em um estudo caso-controle. Resultados: Nós analisamos 172 pacientes, 22,1% com IH, 71,1% adquirida na Unidade. A densidade de incidência de sepse, pneumonia e ITU por 1.000 pacientes/dia foram 17,9, 11,4, e 4,3, respectivamente. Os agentes mais comuns na sepse foram Enterococcus faecalis e Escherichia coli (18% cada), e Staphylococcus epidermidis foram isolados em 13% dos casos. Nas pneumonias Staphylococcus aureus foram os agentes mais comuns (3,2%), e nas ITUs os agentes mais frequentes foram os fungos (33,3%). A presença de IH foi associada com tempo de hospitalização prolongado, uso de procedimentos invasivos (CVC, sonda nasogástrica) e uso de antibióticos. Os dois últimos foram fatores independentes para o desenvolvimento de IH. Conclusões: A incidência de IH adquirida na Unidade foi alta, associada a fatores de risco extrínsecos. Palavras-chaves: Infecções hospitalares. UTI pediátrica. Sistema de vigilância.Nosocomial infection (NI) constitutes a major health pro...

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supporting

confidence: 93%

Nosocomial infections in a pediatric intensive care unit of a developing country: NHSN surveillance

Porto

Mantese

Arantes

et al. 2012

Rev. Soc. Bras. Med. Trop.

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“…This change in etiology toward non-albicans Candida spp. has been seen by other authors also [9][10][11][12][13][14][15][16][17][18][19][20][21]. This finding is worrisome as non-albicans Candida spp.…”

Section: Discussionmentioning

confidence: 63%

“…albicans was considered to be the most common pathogen in paediatric patients with nosocomial candiduria [13][14][15][16][17][18][19]. Our study suggests the shifting trend towards non albicans candida species (57%) compared to Candida albicans (43%).…”

Section: Discussionmentioning

confidence: 74%

“…In our study counts ≤ 10 3 were also considered significant and were processed if same candida species was isolated in three consecutive samples. Colonisation is an important risk factor for development of candidaemia with a high mortality rate of 46-80% compared with bacteraemia (38%) [16]. Also candiduria should never be ignored in septic patients, as it may be the first sign of a systemic Candida infection [17].…”

Section: Discussionmentioning

confidence: 99%

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Occurrence of Candiduria in Paediatric Patients and its Antifungal Susceptibility in a Tertiary Care Centre

Malhotra¹

2017

J Infect Dis Med, an open access journal

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Children with urinary tract infection present with vague clinical features and candiduria in such patients signifies pyelonephritis/cystitis, disseminated candidiasis, contamination or colonisation. This study was aimed to determine the prevalence of candiduria in paediatric patients, their speciation, associated risk factors and antifungal susceptibility of these isolates which will help the clinicians in the better management of candiduria. In our study, the isolation rate for candiduria was 24.3%, more common in males (63%) compared to females (37%) and infants were most commonly involved. Colony count of ≥10 5 cfu/ml seen in 53% of the isolates and pus cells were seen in 84% cases. Among candiduria cases, 87% received broad spectrum antibiotics for more than 7 days, while 57% were catheterized, and 19% of the patients were on fluconazole therapy. In the present study, non-albicans candida species emerged as the predominant pathogen and was found in 57% cases while Candida albicans was found in 43% cases of candiduria. Antifungal susceptibility testing revealed that all the isolates were sensitive to voriconazole and ketoconazole while 95% of the isolates were sensitive to fluconazole and 92% were sensitive to itraconazole. Resistance to fluconazole was found in 5% of isolates while 8% isolates were resistant to itraconazole. Identification of candida species along with antifungal susceptibility is important in patients with UTI and will help the clinician in selecting the appropriate antifungal agent for better management of such cases.

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“…Neste estudo, a análise microbiológica das espécies de Candida sp isoladas na urina de pacientes que desenvolveram candidemia demonstrou que em 43% (10/24) dos casos a espécie isolada na urina foi diferente da espécie isolada do sangue, sendo que a análise molecular realizada nos 14 pares concordantes demonstrou diferença em 2 casos de Candida tropicalis. Globalmente, houve diferenças inter e/ou intra-espécies em 52% das amostras colhidas no sangue e na urina 3 . Estes dados corroboram o conceito de que a infecção do trato urinário baixo é raramente fonte de fungemia 3 7 23 .…”

Section: Dilemas Diagnósticos E Variáveis Determinantes Da Abordagem unclassified

Candidúria: uma abordagem clínica e terapêutica

Colombo

Guimarães

2007

Rev. Soc. Bras. Med. Trop.

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EPIDEMIOLOGIAO termo candidúria, que não necessariamente envolve a presença de sinais e/ou sintomas de infecção urinária, pode ser definido como o crescimento de Candida sp em culturas de urina coletadas por técnicas apropriadas. Trata-se de evento muito freqüente entre pacientes expostos a fatores de risco, sendo que até 20% de pacientes hospitalizados podem apresentar candidúria ao longo de sua internação, particularmente pacientes de unidade de terapia intensiva 6 11 14 17 26 . Este achado laboratorial traz dilemas em relação a sua interpretação, visto que pode corresponder a simples contaminação da coleta de urina até candidúria assintomática, cistite ou pielonefrite, candidíase renal primária, bola fúngica ureteropélvica ou candidíase disseminada com manifestação renal 16 37 . Candidúria: uma abordagem clínica e terapêutica ABSTRACT Candiduria remains a controversial issue for clinicians once that it may represent a broad variety of possibilities including colonization, local or systemic infection. We will discuss the epidemiology, diagnosis and treatment of candiduria in different settings of patients, including renal transplant recipients. Definitions on therapy are mostly based on epidemiological and clinical data. Once antifungal therapy is required the following antifungal treatment may be used: intravenous amphotericin B, bladder irrigation with amphotericin B or fluconazole. Blood cultures may be required in patients with candiduria and high risk for developing hematogenous infection. Removal of the urinary catheter must be considered in order to avoid persistent candiduria and recurrence.Key-words: Candiduria. Nosocomial infection. Antifungal drugs. Candida.Entre pacientes hospitalizados, vários fatores têm sido reconhecidos como relacionados a um maior risco para o desenvolvimento de candidúria: idade avançada, sexo feminino, antibioticoterapia de amplo espectro, o uso de corticosteróides e imunossupressores, presença de anormalidades do trato urinário, diabetes, sondagem vesical de demora, pós-operatório de cirurgias de grande porte e doenças malignas 12 16 17 20 39 (Tabela 1). Importante observar que a diabetes é a doença de base mais frequentemente encontrada nestes pacientes, condição esta associada a neuropatia autonômica que pode evoluir com retenção de urina, episódios de infecção urinária bacteriana (uso de antibióticos recorrente) e necessidade de sondagens de alívio. Em relação à sondagem vesical de demora, o tempo de uso deste dispositivo parece ter relação direta com o risco de desenvolvimento de candidúria. Em estudo conduzido por

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Investigation of the possible association between nosocomial candiduria and candidaemia

Cited by 69 publications

References 37 publications

Nosocomial infections in a pediatric intensive care unit of a developing country: NHSN surveillance

Nosocomial infections in a pediatric intensive care unit of a developing country: NHSN surveillance

Occurrence of Candiduria in Paediatric Patients and its Antifungal Susceptibility in a Tertiary Care Centre

Candidúria: uma abordagem clínica e terapêutica

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