[Candiduria in patients with urethral catheter admitted in Intensive Care Unit. Etiology and in vitro susceptibility to fluconazole].
BACKGROUND
The isolation of Candida species in urine in patients admitted in intensive care units who bear a vesical catheter is considered as a sign of bad prognosis. The etiological mechanisms and the appropriateness of administering an antifungal treatment in these patients is controversial.


METHODS
The prevalence of Candida species in urine and the in vitro susceptibility to fluconazole by means of the E-test were determined in 560 patients admitted in an intensive care unit.


RESULTS
In 60 patients (11%) Candida species was isolated in urine after catheter replacement. 56.7% of isolates corresponded toC. albicans, 21.7% to C. glabrata, 15% to C.tropicalis, 5% to C. parapsilosis and 1.7% to C.kefyr. Only two isolates (C. albicans and C. glabrata)had a minimal inhibitory concentration (MIC) >= 64 microgram/ml (which was regarded as resistant) and 91% of strains had a MIC between 0.125 and 8 microgram/ml. MIC 90% for C. albicans and C. tropicalis was 1 microgram/ml,while it was 16 microgram/ml for C. glabrata. C. albicans is the most frequent species isolated in urine in these patients. However,over 40% of cases are found to have non-albicans species,especially C. glabrata and C. tropicalis. The majority of Candida isolates (91%) are sensitive in vitro to fluconazole.
Morera
Yolanda
Y
IMIM/IMAS, Universitat Autònoma de Barcelona, Spain. ymorera@imim.es
Torres-Rodríguez
Josep Maria
JM
Catalán
Iñaki
I
Granadero
Ana
A
Josic
Zoran
Z
Alvarez-Lerma
Francisco
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000494:pharmacology*; D002175:Candida / Q000187:drug effects* / Q000302:isolation & purification; D005260:Female; D015725:Fluconazole / Q000494:pharmacology*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011446:Prospective Studies; D014521:Urethra; D014546:Urinary Catheterization; D014556:Urine / Q000382:microbiology*
D000935:Antifungal Agents; D015725:Fluconazole