title: Candiduria in haematologic malignancy patients without a urinary catheter: nothing more than a frailty marker?
abstract: There is scarcity of data regarding significance of candiduria in patients with haematologic malignancies and its association with invasive candidiasis. To that end, we retrospectively evaluated all hospitalised, non-intensive care unit patients with haematologic malignancies and candiduria during a 10-year period (2001-2011). To decrease the possibility of bladder colonisation and sample contamination, we excluded all patients with candiduria who had urinary catheters and those with concomitant bacteriuria. Twenty-four such patients (21 females) were identified, with median age at diagnosis 62 years (range, 20-82 years). Acute leukaemia was the most common underlying disease (54%); 62% of these cases were not in remission. Twenty-nine percent of the patients had diabetes mellitus and 25% were neutropenic. The most common isolated Candida species was Candida glabrata (37%), followed by C. 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). Isolated candiduria in patients with haematologic malignancies has risk factors similar to those in other hospitalised patients, and it does not seem to be a strong predictor of subsequent invasive candidiasis.
authors.affiliation: Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: Sarah P
authors.initials: SP
authors.lastname: Georgiadou
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Tarrand
authors.forename: Nikolaos V
authors.initials: NV
authors.lastname: Sipsas
authors.forename: Dimitrios P
authors.initials: DP
authors.lastname: Kontoyiannis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000627:therapeutic use*; D041221:Candida glabrata / Q000302:isolation & purification; D058365:Candidiasis, Invasive / Q000188:drug therapy / Q000473:pathology*; D003920:Diabetes Mellitus / Q000473:pathology; D005260:Female; D019337:Hematologic Neoplasms / Q000382:microbiology* / Q000473:pathology; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000473:pathology*; D008875:Middle Aged; D009503:Neutropenia / Q000473:pathology; D011776:Pyuria / Q000175:diagnosis / Q000382:microbiology; D012189:Retrospective Studies; D012307:Risk Factors; D062885:Urinary Catheters; D014552:Urinary Tract Infections / Q000382:microbiology / Q000652:urine; D055815:Young Adult
chemical_list: D000935:Antifungal Agents