Catheter-associated candiduria: Risk factors, medical interventions, and antifungal susceptibility

Padawer, Dan; Pastukh, Nina; Nitzan, Orna; Labay, Kozitta; Aharon, Ilana; Brodsky, Diana; Glyatman, Tatyana; Peretz, Avi

doi:10.1016/j.ajic.2015.03.013

Cited by 32 publications

(35 citation statements)

References 16 publications

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“…The overall candiduria rate was 8.3% (35 out of 422). Similarly, Goyal et al [2], Zarei et al [16], and Padawer et al [17] reported candiduria in 2.36%, 16.5%, and 19.49% of their study populations, respectively. In a comparative study by da Silva Krenke et al [18], candiduria was reported in 30% and 16% of diabetic and non-diabetic patients, respectively.…”

Section: Discussionmentioning

confidence: 61%

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

et al. 2016

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Background and Purpose:The presence of Candida yeasts in urine, known as candiduria, is an indicator of infection or colonization of the urinary tract by Candida species. This condition in diabetic patients can be hazardous due to diminished immune system response. The objective of this study was to investigate the incidence of candiduria in diabetic patients and to identify its causative agents. Furthermore, the demographic and laboratory (HbA1c, urine glucose and pH, urine culture colony count, and fasting blood sugar) data and their possible associations with candiduria were investigated.Materials and Methods:This cross-sectional, descriptive study was performed on 305 diabetic patients referred to the diabetes research center, Hamedan, Iran, during April 2015 to September 2015. Urine and blood specimens were collected and urine analysis, urine culture, FBS, and HbA1c tests were performed. Positive cases were subjected to colony count and the causative agents were subsequently identified through the routine identification tests, as well as colony color in CHROMagar Candida medium, and the assimilation patterns in API 20 C auxanographic method.Results:Among the 305 cases, 38 (%12.5) were positive for candiduria. Causative agents were identified as Candida glabrata (n=19, 50%), C. albicans (n=12, 31.6%), C. krusei (n=4, 10.5%), C. tropicalis (n=2, 5.3%), andC. kefyr (n=1, 2.6%). According to the results of the statistical analyses, there were significant association between candiduria and female gender, high FBS and urine glucose, uncontrolled diabetes (HbA1c ≥8), and acidic urine pH (P<0.05).Conclusion:Considering the high incidence rate of candiduria in diabetic patients, control of diabetes, predisposing factors, and causal relationships between diabetes and candiduria should be highlighted.

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Section: Discussionmentioning

confidence: 61%

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

et al. 2016

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“…Neither urinary catheter or prior antibiotic exposure contributed significantly to our model, but when combined together demonstrated a decreased risk of candidaemia in candiduric patients. This finding is likely because they increase urinary colonisation synergistically.Urinary catheterisation provides a direct portal of entry into the bladder, allowing microbes to establish infection either via an extraluminal or intraluminal pathway 25,39. While ß-lactam/ß-lactamase inhibitor use is associated with an increased risk for candidaemia likely by its influence on the intestinal microbial flora, prior antibiotic exposure altogether may have a greater effect on the lower genital tract, altering the microbiome and increasing Candida colonisation 25.…”

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confidence: 99%

Creation and assessment of a clinical predictive model for candidaemia in patients with candiduria

Wang

Hsueh

Kronen

et al. 2019

Mycoses

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Summary Candidaemia is the most common clinical presentation of invasive candidiasis and is a major cause of morbidity and mortality. Candiduria is a predictor for candidaemia; however, patient characteristics that are associated with concurrent candidaemia in the setting of candiduria are unclear. Identifying these characteristics could aid in the early detection of systemic disease. We performed a retrospective cohort analysis of hospitalised patients with candiduria at our institution over a 13‐year period. Our evaluation of patient characteristics included demographics, comorbidities, medications, procedures, devices, vital signs and laboratory values. We developed a multivariable logistic model to identify factors associated with candidaemia in patients with candiduria. We identified 4240 patients with candiduria, 263 (6.2%) of whom had candidaemia. Predictors for increased risk of candidaemia with candiduria included hospitalisations > 12 days, central venous catheter, parenteral nutrition, haematological and gynaecological malignancy, and receipt of β‐lactam/β‐lactamase inhibitors. Vital signs and laboratory values associated with candidaemia included elevated heart rate, temperature and creatinine, along with neutropenia and neutrophilia. Factors that demonstrated a decreased risk of candidaemia included diabetes mellitus, gastrostomy and urinary catheter with antibiotic use. The c‐statistic was 0.741 (95% CI, 0.710‐0.772). We identified a set of clinical characteristics that can predict the presence of candidaemia with candiduria.

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“…Numerous authors (19)(20)(21)(22) reported that the most frequently occurring fungal microorganism in clinical materials is C. albicans, followed by C. glabrata, C. tropicalis, and C. krusei. We detected mostly C. parapsilosis (31.4%), C. albicans (26.5%), and C. tropicalis (12.4%), followed by C. robusta (9.1%) and other NAC species.…”

Section: Discussionmentioning

confidence: 99%

Fluorescent Capillary Electrophoresis Is Superior to Culture in Detecting Candida Species from Samples of Urinary Catheters and Ureteral Stents with Mono- or Polyfungal Biofilm Growth

et al. 2019

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Molecular techniques in fungal detection and identification represent an efficient complementary diagnostic tool which is increasingly used to overcome limitations of routinely used culture techniques. The aim of this study was to characterize Candida sp. representation in samples from urine, urinary catheter, and ureteral stent biofilm using ITS2 ribosomal DNA (rDNA) amplification followed by fluorescent capillary electrophoresis (f-ITS2-PCR-CE) and to compare the results with those obtained by culture. A total of 419 samples were analyzed, and 106 (25.2%) were found positive, out of which 17 (16%) were polyfungal. The positivity rate did not differ between samples from catheters and stents (23.6% versus 20.9%) or between catheter and stent corresponding urine samples (40.2% versus 30.2%). Ten different Candida species were detected, with Candida parapsilosis (31.4%), Candida albicans (26.5%), and Candida tropicalis (12.4%) predominating. f-ITS2-PCR-CE was evaluated as substantially less time-consuming and 8.3 times more sensitive than the routinely applied culture technique with 1 l of urine/sonicated fluid inoculated, detecting 67 (19.9%) versus 8 (2.4%) positive samples out of 337 initially analyzed samples. The culture sensitivity considerably improved to 1.7 times lower than that of f-ITS2-PCR-CE after the inoculation volume was increased to 100 l in the additional 82 samples. Moreover, the molecular technique, unlike routine cultivation, enabled precise pathogen composition determination in polymicrobial samples. In conclusion, the f-ITS2-PCR-CE method was shown to be a quick and efficient tool for culture-independent detection and identification of fungi in urinary tract-related samples, demonstrating a higher sensitivity than culture.

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Catheter-associated candiduria: Risk factors, medical interventions, and antifungal susceptibility

Cited by 32 publications

References 16 publications

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

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

Creation and assessment of a clinical predictive model for candidaemia in patients with candiduria

Fluorescent Capillary Electrophoresis Is Superior to Culture in Detecting Candida Species from Samples of Urinary Catheters and Ureteral Stents with Mono- or Polyfungal Biofilm Growth

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