Management of candiduria in hospitalized patients: a single-center study on the implementation of IDSA guidelines and factors affecting clinical decisions

He, Zhengxin; Huo, Xiaosai; Lei, Daxin; Zhao, Hui-Hai; Jia, Keran; Wang, Fukun

doi:10.1007/s10096-020-03999-1

Cited by 7 publications

(4 citation statements)

References 31 publications

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“…Female gender and diabetes were associated with candiduria, which was consistent with many previous studies. 18,19 We have found that pneumonia patients were prone to develop candiduria in another retrospective study, 20 which was once again confirmed in this observational study. We may speculate the fact that the ICU pneumonia patients often experience a long period of intensive use of antibiotics, which has been recognized as an important risk factor for candiduria.…”

Section: Discussionsupporting

confidence: 83%

“…Candida colonization is considered to be associated with IC, and multisite colonization is an important risk factor in clinic. 20,28 Several risk assessment tools including colonization index (CI), 29 corrected colonization index (CCI) 30 and Candida score (CS) 31 are used to evaluate the possibility of IC in critical patients. Among these tools, multisite Candida colonization is an important clinical reference index.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of a Novel Laboratory Candiduria Screening Protocol in the Intensive Care Unit

He¹,

Su²,

Bi³

et al. 2021

IDR

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Background: Since urine cultures are only guaranteed for patients with obvious urinary symptoms in most cases, most of candiduria episodes are ignored in clinic. Objective: This study aimed to design a screening protocol to improve diagnostic efficiency of candiduria, and provide information of Candida species and drug susceptibility. Methods: All patients, who were admitted to the intensive care unit (ICU) of our hospital during December 1, 2018 and October 1, 2019, were enrolled in this study. Urinalysis was performed every three days for each subject from the first day of ICU admission. Urine specimens were sampled for fungal culture with either condition: (1) yeast-like cell counting (YLCC) ≥200; (2) positive YLCCs were observed in two consecutive tests, and at least one YLCC ≥100. Results: The screening protocol dramatically improved the candiduria diagnostic rate of ICU patients from 2.28% to 17.27%. However, compared to the historical control, the screening protocol has no time-saving advantage in candiduria diagnosing. Higher percentage of C. albicans in screening protocol-identified candiduria patients was observed, although there was no statistical difference. Our results indicated that female gender, pneumonia, diabetes and infarction/hemorrhage patients were more prone to develop candiduria. Non-candiduria patients showed a better tendency for survival and shorter ICU stay length. Multisite colonization was common in the surveyed candiduria patients, who were up to 70.83% showed Candida positive cultures in sputum. Conclusion: The screening protocol established in the study was a convenient and practical tool for early warning and feasible management of candiduria and IC.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Evaluation of a Novel Laboratory Candiduria Screening Protocol in the Intensive Care Unit

He¹,

Su²,

Bi³

et al. 2021

IDR

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“…13 An increase in non-albicans species appears as a significant problem due to decreased susceptibility of nonalbicans species to antifungals, which may result in complexities or failures in the management of UTIs. 14 This study aimed to determine the epidemiological, clinical, and mycological characteristics of Candida urinary infections in intensive care unit (ICU) patients and antifungal susceptibilities of Candida species.…”

Section: Introductionmentioning

confidence: 99%

An epidemiologic analysis of Candida spp. urinary infections in intensive care unit

Ekşi¹,

Hassan²,

Uğur³

et al. 2022

Rev Epidemiol Control Infect

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Background and objectives: The finding of Candida species in urine is an usual finding and is called candiduria. There is an increase in the frequency of urinary tract infections (UTI) caused by Candida especially in critically ill patients. This study aimed to determine the epidemiological, clinical, and mycological characteristics of Candida urinary infections in intensive care unit (ICU) and antifungal susceptibilities. Methods: Urine cultures of 394 ICU patients with clinical suspicion of UTI were evaluated. After 24-48 hours of incubation, colonies appeared to grow as yeast, were morphologically examined by Gram staining. Candida strains that grew 104 ≥ CFU/mL in urine cultures were accepted as candiduria. The susceptibilities of the Candida strains to amphotericin B, itraconazole, fluconazole, voriconazole, flucytosine, and caspofungin were investigated with broth microdilution method. Results: The distribution of the isolated 100 urinary Candida strains were as, 54 Candida albicans, 34 C. glabrata, 7 C. tropicalis, 2 C. kefyr, 2 C. lusitaniae, and 1 as C. parapsilosis. Among 100 Candida species isolated in our study susceptibility rates of amphotericin B, flucytosine, caspofungin, fluconazole, itraconazole, and voriconazole were 100%, 100%, 91%, 23%, 13%, 25.8%, respectively. Conclusion: Accurate identification of Candida spp., as well as the investigating the antifungal susceptibility, will be beneficial in terms of the effectiveness of the treatment and the prevention of resistance development.

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“…It is mainly associated with diabetic patients, because diabetes alters the normal host system, which may contribute to the development of UTI (Woldemariam et al, 2019). In recent years, urinary tract infections caused by Candida opportunistic pathogens are becoming more frequent and accounted for 10-15% of UTIs (Goyal et al, 2016;Chandak et al, 2018;He et al, 2021). The yeast-like fungus Candida spp.…”

Section: Introductionmentioning

confidence: 99%

Biofilm formation by Candida albicans and Candida glabrata isolated from urine specimens of diabetic Iraqi women

Ibrahim¹,

Hamzah²

2021

JLBSR

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Biofilms are multicellular communities where microorganisms are grown and form an extracellular matrix that protects the pathogenic microorganisms from the immunity system and antimicrobial agents. This study is aimed to identify Candida spp. isolated from urine specimens by using traditional techniques, germ tube, growth on corn meal agar medium and chromogenic medium then determine the ability of isolates to producing biofilm by tube method (TM) and congo red agar method (CRA). In our study urine specimens were obtained from 174 diabetic females in the period of six months at the Al-Wafa Specialized Center for Diabetes and Endocrinology, Mosul city, Iraq. Out of the total 174 specimens, yeast species were isolated from 56 (32.2 %) specimens. Out of the 56 isolates, 50 isolates were positive for Candida spp., especially C. glabrata which appeared maximum in 30 isolates (60 %) and followed by C. albicans 18 isolates (36%) and C. krusei 2 isolates (4 %). In the TM method for biofilm detection, C. albicans showed 16 isolates (88.9%) positive for biofilm formation followed by 29 isolates (96.7%) of C. glabrata. Furthermore, in the CRA method, all isolates (100%) of C. albicans were negative followed by 27 isolates (90%) of C. glabrata, whereas only 3 isolates (10%) of C. glabrata were positive. We can conclude that TM is the best conventional method and is sensitive to detect biofilm-forming yeast when compared with the CRA method.

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Management of candiduria in hospitalized patients: a single-center study on the implementation of IDSA guidelines and factors affecting clinical decisions

Cited by 7 publications

References 31 publications

Evaluation of a Novel Laboratory Candiduria Screening Protocol in the Intensive Care Unit

Evaluation of a Novel Laboratory Candiduria Screening Protocol in the Intensive Care Unit

An epidemiologic analysis of Candida spp. urinary infections in intensive care unit

Biofilm formation by Candida albicans and Candida glabrata isolated from urine specimens of diabetic Iraqi women

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