Candiduria in haematologic malignancy patients without a urinary catheter: nothing more than a frailty marker?

Abstract

Summary Background There is scarcity of data regarding significance of candiduria in patients with hematologic malignancies and its association with invasive candidiasis. Patients and Methods To that end, we retrospectively evaluated all hospitalized, non-intensive care unit patients with hematologic malignancies and candiduria during a 10-year period (2001-2011). To decrease the possibility of bladder colonization and sample contamination, we excluded all patients with candiduria who had urinary catheters and those with concomitant bacteriuria. Results Twenty-four such patients (21 females) were identified, with median age at diagnosis 62 years (range, 20-82 years). Acute leukemia was the most common underlying disease (54%); 62% of these cases were not in remission. Twenty-nine % of the patients had diabetes mellitus and 25% were neutropenic. The most common isolated Candida species was Candida glabrata (37%), followed by Candida albicans (29%). Only 8% of them had urinary tract infection symptoms. However, 88% received systemic antifungals. Candidemia and crude mortality rates at 4 weeks were low (4% and 12%, respectively). Conclusions Isolated candiduria in patients with hematologic malignancies has risk factors similar to those in other hospitalized patients, and it does not seem to be a strong predictor of subsequent invasive candidiasis.

Candiduria in kidney transplant recipients: Is antifungal therapy useful?

“…We observed a high mortality rate (15%); this is likely a marker for severity of illness, rather than the consequence of candiduria itself, as suggested by previous studies in general population: Kauffman et al observed an overall mortality of 19.8%, but candiduria‐related mortality was only 0.4%. In our study, treatment had no significant effect on complications nor on survival rate.…”

Characterization and identification of candiduria due to Candida species in diabetic patients

“…Although C. albicans is reported as the major Candida species causing candiduria in some studies [ 3 , 16 , 19 , 20 ], an increasing trend in the prevalence of candiduria due to non- albicans Candida species was shown by some researchers [ 2 , 21 - 23 ]. In the present study, C. glabrata was the most isolated species (50%) followed by C. albicans (31.6%), C. krusei (10.5%), C. tropicalis (5.3%), and C. kefyr (2.6%).…”

“…According to the data from a study conducted by Georgiadou et al [ 23 ], female gender, multiple hospitalization, broad-spectrum antimicrobial the-rapy, renal dysfunction, intensive care unit admission, and diabetes mellitus are predisposing factors of candiduria in patients with hematologic malignancy. In addition to urinary system disorders following candiduria, candidemia is reported to be significantly associated with the candiduria [ 26 ], which underscores the importance of this condition.…”

Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America

“…Many physicians who care for neutropenic patients treat those who have fever and candiduria because the candiduria may indicate invasive candidiasis. However, a recent study from a cancer hospital of a small number of patients, 25% of whom were neutropenic, found that these patients did not develop candidemia or other complications of candiduria [484]. Several reports have documented a high rate of candidemia when patients undergo urinary tract instrumentation [485,486], which has led to recommendations to treat with antifungal agents periprocedure.…”