Long-term follow-up of patients with candiduria

Abstract

Candiduria is commonly encountered in hospitalized patients, particularly those with indwelling urinary catheters. While risk factors and therapy are well described in previous studies, little is known about long-term outcomes and recurrence rates of candiduria. We studied 188 patients with candiduria in a retrospective chart review at a single institution from January 1999 to December 2000. Data were collected regarding risk factors and underlying disease, therapy, follow-up cultures until December 2003, and mortality. Ninety-one patients with at least one follow-up culture >1 month after the initial culture (range 2-48) were available for further study. In this group, patients receiving antifungal therapy for asymptomatic candiduria were paradoxically more likely to have subsequent positive urine cultures than patients who never received antifungal therapy. Six patients developed candidemia during follow-up, although in none was this considered to represent a consequence of candiduria. Mortality rate at the end of the follow-up period (mean of 18 months) was 43%, including one death attributed to candidemia. Therapy for candiduria does not appear to reduce candiduria recurrence rates through 48 months of follow-up and little evidence of treatment benefit was identified.

ESCMID guideline for the diagnosis and management of Candida diseases 2012: non-neutropenic adult patients

“…Evidence. Asymptomatic candiduria has been followed long term, but no adverse consequences have been described [99]. Funguria resolved without specific treatment in 76% of a large ( N = 861) clinical cohort [100].…”

Epidemiological Study on Species Identification and Susceptibility Profile of Candida in Urine

“…Recent studies highlight the changing epidemiology of community and nosocomial candiduria [6,7,14,18]. Our data showed that C. albicans remained as the prominent species isolated from urine cultures in both community and hospital setting, 85% and 68% respectively.…”

“…Total ICUs bed capacity are 60. The patients were eligible if the urine sample yielded the growth of Candida species with a count of 10 3 colony-forming units (CFU) which is considered as candiduria [14]. For the isolate to be significant causing CUTI, the patient either had symptoms suggested of UTI supported by positive urine routine in patients culture without catheters, or in catheterized patients, two consecutive cultures of urine samples were positive for Candida species after changing the indwelling catheters.…”

“…Invasive candidiasis defined as outlined in recent publications [14,15]. Epidemiological data and risk factors of the patients were collected including, gender, age, clinical presentation and treatment option.…”

Strategies for antifungal treatment failure in intensive care units

“…Bei tiefen Infektionen, wie z. B. des Auges, der Herzklappen, des Gehirns oder bei einer hepatolienalen Candidiasis werden hingegen Azole oder liposomales Amphotericin B Keine Therapie (A II) e[155] Entfernung/Wechsel des Blasenkatheters (B I) d[155][156][157] Fluconazol (C I)[155] Blaseninstallation mit Amphotericin B (C II) f[158,155] Fluconazol (A II)[178] Liposomales Amphotericin B gefolgt von Fluconazol (A II)[179,180] Voriconazol (B II)[153] Caspofungin, gefolgt von Fluconazol (B II)[100] Posaconazol (C III)[181] Chirurgisches Débridement i[179] Tab. 3 Auszug aus den ESCMID-Guidelines für die verschiedenen Formen der Candida-Infektionen[20] doch eine zunehmende Rolle von erworbenen Resistenzen.…”