Catheter-associated candiduria: Risk factors, medical interventions, and antifungal susceptibility.
BACKGROUND
Catheter-associated candiduria is a common clinical finding in hospitalized patients, especially in the intensive care unit. The objective of this study was to obtain demographic and clinical data regarding the prevalence of Candida spp in catheterized in-patients and the medical interventions provided to these patients in a northern Israeli hospital between 2011 and 2013.


METHODS
Isolation and identification of microorganisms were performed on 1,408 urine culture samples 48 hours after catheter insertion. Antifungal Etest susceptibility tests were carried out on every Candida-positive urine sample. Demographic and clinical data were gathered to determine risk factors and medical interventions.


RESULTS
Candiduria was detected in 146 catheterized in-patients out of the 1,408 patients included in this study. C albicans was detected in most cases (69.1%). Fever was observed in 52 (35.61%) patients, and leukocyturia was observed in 48 cases (32.87%). Diabetes mellitus was associated with C albicans candiduria. There were 93 patients (63.69%) who did not receive any medical intervention for their candiduria.


CONCLUSIONS
Candida is the second leading pathogen causing catheter-associated urinary tract infection or asymptomatic colonization, whereas previous studies showed Candida as the third leading pathogen. Clinical signs and symptoms, such as fever and laboratory tests, cannot distinguish between asymptomatic colonization and infection. Because the management of catheter-associated candiduria is still controversial, additional studies should be carried out.
Faculty of Medicine in the Galilee, Bar Ilan University, Safed, Israel.
Dan
D
Padawer
Clinical Microbiology Laboratory, Baruch Padeh Medical Center, Poriya, Affiliated with the Faculty of Medicine in the Galilee, Bar Ilan University, Israel.
Nina
N
Pastukh
Infectious Diseases Unit, Baruch Padeh Medical Center, Poriya, Affiliated with the Faculty of Medicine in the Galilee, Bar Ilan University, Israel.
Orna
O
Nitzan
Infectious Diseases Unit, Baruch Padeh Medical Center, Poriya, Affiliated with the Faculty of Medicine in the Galilee, Bar Ilan University, Israel.
Kozitta
K
Labay
Infectious Diseases Unit, Baruch Padeh Medical Center, Poriya, Affiliated with the Faculty of Medicine in the Galilee, Bar Ilan University, Israel.
Ilana
I
Aharon
Clinical Microbiology Laboratory, Baruch Padeh Medical Center, Poriya, Affiliated with the Faculty of Medicine in the Galilee, Bar Ilan University, Israel.
Diana
D
Brodsky
Clinical Microbiology Laboratory, Baruch Padeh Medical Center, Poriya, Affiliated with the Faculty of Medicine in the Galilee, Bar Ilan University, Israel.
Tatyana
T
Glyatman
Clinical Microbiology Laboratory, Baruch Padeh Medical Center, Poriya, Affiliated with the Faculty of Medicine in the Galilee, Bar Ilan University, Israel. Electronic address: aperetz@poria.health.gov.il.
Avi
A
Peretz
D000935:Antifungal Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002175:Candida / Q000187:drug effects* / Q000302:isolation & purification; D002177:Candidiasis / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D055499:Catheter-Related Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D052978:Disk Diffusion Antimicrobial Tests; D005260:Female; D006761:Hospitals; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology
D000935:Antifungal Agents
Candida; Candiduria; Catheter; Catheter-associated candiduria; Susceptibility; Urinary tract infection