Prospective Multicenter Surveillance Study of Funguria in Hospitalized Patients

Abstract

Although fungal urinary tract infections are an increasing nosocomial problem, the significance of funguria is still not clear. This multicenter prospective surveillance study of 861 patients was undertaken to define the epidemiology, management, and outcomes of funguria. Diabetes mellitus was present in 39% of patients, urinary tract abnormalities in 37.7%, and malignancy in 22.2%; only 10.9% had no underlying illnesses. Concomitant nonfungal infections were present in 85%, 90% had received antimicrobial agents, and 83.2% had urinary tract drainage devices. Candida albicans was found in 51.8% of patients and Candida glabrata in 15.6%. Microbiological and clinical outcomes were documented for 530 (61.6%) of the 861 patients. No specific therapy for funguria was given to 155 patients, and the yeast cleared from the urine of 117 (75.5%) of them. Of the 116 patients who had a catheter removed as the only treatment, the funguria cleared in 41 (35.3%). Antifungal therapy was given to 259 patients, eradicating funguria in 130 (50.2%). The rate of eradication with fluconazole was 45.5%, and with amphotericin B bladder irrigation it was 54.4%. Only 7 patients (1.3%) had documented candidemia. The mortality rate was 19.8%, reflecting the multiple serious underlying illnesses found in these patients with funguria.

Candida colonization in intensive care unit patients' urine

“…Some investigators have showed that use of antibiotics, presence of central venous catheter, and prolonged hospital permanence represent important risk factors for the development of microorganisms (Kauffman et al 2000, Blumberg et al 2001, Simpson et al 2004). We verified in our work that all patients were under antibiotic use (100%).…”

Escherichia coli 83972 inhibits catheter adherence by a broad spectrum of uropathogens

“…These three organisms were specifically chosen because they are major causes of bacteriuria and/or UTI in chronically catheterized persons. 14,15 …”

Candidúria: uma abordagem clínica e terapêutica

“…No estudo de Kauffman e cols 17 , onde um total de 861 episódios de candidúria em pacientes hospitalizados foi avaliado, Candida albicans respondeu por 52% dos isolados, seguido por Candida glabrata e Candida tropicalis 16 (Tabela 2). 3 18 27 29 (Tabela 3).…”

“…No estudo multicêntrico realizado por Kauffman e cols 17 onde mais de 800 pacientes foram avaliados, apenas 1% deles evoluíram com candidemia 17 . Em outra série de casos avaliada por Sobel e cols 36 , nenhum paciente com candidúria evoluiu para doença disseminada 36 .…”