Prospective Multicenter Surveillance Study of Funguria in Hospitalized Patients
Clinical Infectious Diseases January 2000 V.30 N.1 P.14-18
Carol A. Kauffman, José A. Vazquez, Jack D. Sobel, Harry A. Gallis, David S. McKinsey, A. W. Karchmer, Alan M. Sugar, Patricia Kay Sharkey, Gilbert J. Wise, Richard Mangi, Ann Mosher, Jeannette Y. Lee, William E. Dismukes, and National Institute for Allergy and Infectious Diseases (NIAID) Mycoses Study Group
1University of Michigan and Veterans Affairs Medical Center, Ann Arbor, Michigan
2Wayne State University Medical Center, Detroit, Michigan
3Duke University Medical Center, Durham, North Carolina
4Infectious Diseases Associates of Kansas City, Kansas City, Missouri
5Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
6Boston University Medical School, Boston, Massachusetts
7University of Texas Health Science Center at San Antonio, San Antonio, Texas
8Maimonides Medical Center, Brooklyn, New York
9St. Raphael Medical Center, New Haven, Connecticut
10University of Alabama Medical Center, Birmingham, Alabama
Although fungal urinary tract infections are an increasing nosocomial problem, the significance of funguria is still not clear.
This multicenter prospective surveillance study of 861 patients was undertaken to define the epidemiology, management, and outcomes of funguria.
Diabetes mellitus was present in 39% of patients, urinary tract abnormalities in 37.7%, and malignancy in 22.2%; only 10.9% had no underlying illnesses. Concomitant nonfungal infections were present in 85%, 90% had received antimicrobial agents, and 83.2% had urinary tract drainage devices.
Candida albicans was found in 51.8% of patients and Candida glabrata in 15.6%. Microbiological and clinical outcomes were documented for 530 (61.6%) of the 861 patients.
No specific therapy for funguria was given to 155 patients, and the yeast cleared from the urine of 117 (75.5%) of them. Of the 116 patients who had a catheter removed as the only treatment, the funguria cleared in 41 (35.3%).
Antifungal therapy was given to 259 patients, eradicating funguria in 130 (50.2%). The rate of eradication with fluconazole was 45.5%, and with amphotericin B bladder irrigation it was 54.4%. Only 7 patients (1.3%) had documented candidemia.
The mortality rate was 19.8%, reflecting the multiple serious underlying illnesses found in these patients with funguria.
Entry filed under: Antimicoticos, Biología Molecular, Epidemiología, Health Care-Associated Infections, Infecciones micoticas, Infecciones nosocomiales, Infecciones urinarias, Metodos diagnosticos, Sepsis, Update. Tags: .