Abstract
A retrospective review of urine cultures obtained from patients at the University of Illinois Hospital revealed that the frequency of isolation of non-albicans Candida species increased significantly from 1990 to 1991 (p=0.0003), while the frequency of isolation ofCandida albicans species decreased significantly (p=0.0006). Patients with urine cultures positive for non-albicans Candida species orTorulopsis glabrata during 1991 were identified for review. Sixty-seven patients were eligible for evaluation. Non-albicans candiduria developed in an average of 12 days. Identical fungal species were isolated from the blood following a positive urine culture in only two patients. Twenty patients were treated; candiduria persisted in 9 (45 %), while resolution occurred in 11 (55 %). The remaining 47 patients were not treated. Non-albicans candiduria persisted in 30 (64 %) of these patients and resolved in 15 (32 %); in the remaining two patients (4 %) the microbiologic outcome was undetermined. The difference in microbiologic outcomes between treated and untreated patients was not significant using the Chi-square test (p=0.170). Non-albicans candiduria developed rapidly, frequently persisted whether treated or untreated, and rarely progressed to candidemia.
Similar content being viewed by others
References
Schaberg DR, Culver DH, Gaynes RP: Major trends in the microbial etiology of nosocomial infection. American Journal of Medicine 1991, 91, Supplement 3B: 72–75.
Michigan S: Genitourinary fungal infections. Journal of Urology 1976, 116: 390–397.
Rivett AG, Perry JA, Cohen J: Urinary candidiasis: a prospective study in hospital patients. Urological Research 1986, 14: 183–186.
Haley LD: Yeast infections of the lower urinary tract: in vitro studies of the tissue phase of Candida albicans. Sabouraudia 1965, 4: 98–105.
Frye KR, Donovan JM, Drach GW:Torulopsis glabrata urinary infections: a review. Journal of Urology 1988, 139: 1245–1249.
Merz WG:Candida lusitaniae: frequency of recovery, colonization, infection, and amphotericin B resistance. Journal of Clinical Microbiology 1984, 20: 1194–1195.
Baker JG, Nadler HL, Forgacs P, Kurtz SR:Candida lusitaniae: a new opportunistic pathogen of the urinary tract. Diagnostic Microbiology and Infectious Diseases 1984, 2: 145–149.
Sandford GR, Merz WG, Wingard JR, Charache P, Saral R: The value of fungal surveillance cultures as predictors of systemic fungal infections. Journal of Infectious Diseases 1980, 142: 503–509.
Wingard JR, Merz WG, Saral R:Candida tropicalis: a major pathogen in immunocompromised patients. Annals of Internal Medicine 1979, 91: 539–543.
Hamory BH, Wenzel RP: Hospital-associated candiduria: predisposing factors and review of the literature. Journal of Urology 1978, 120: 444–448.
Wey SB, Mori M, Pfaller MA, Woolson RF, Wenzel RP: Risk factors for hospital-acquired candidemia: a matched case-control study. Archives of Interinal Medicine 1989, 149: 2349–2353.
Bross J, Talbot GH, Maislin G, Hurwitz S, Strom BL: Risk factors for nosocomial candidemia: a case-control study in adults without leukemia. American Journal of Medicine 1989, 87: 614–620.
Hasenclaver HF, Mitchell WD: Pathogenicity ofC. albicans andC. tropicalis. Sabouraudia 1961, 1: 16–21.
Hasenclaver HF, Mitchell WD: Pathogenesis ofTorulopsis glabrata in physiologically altered mice. Sabouradia 1963, 2: 271–283.
Wingard JR, Dick JD, Merz WG, Sandford GR, Saral R, Burns WH: Differences in virulence of clinical isolates ofCandida tropicalis andCandida albicans in mice. Infection and Immunity 1982, 37: 833–836.
Fromtling RA, Abruzzo GK, Giltinan DM:Candida tropicalis infection in normal, diabetic, and neutropenic mice. Journal of Clinical Microbiology 1987, 25: 1416–1420.
Kozinn PJ, Paschdjian CL, Goldberg PK, Wise GJ, Toni EF, Seelig MS: Advances in the diagnosis of renal candidiasis. Journal of Urology 1978, 119: 184–187.
Wise GJ, Goldberg P, Kozinn PJ: Genitourinary candidiasis: diagnosis and treatment. Journal of Urology 1976, 116: 778–780.
Goldberg PK, Kozinn PJ, Wise GJ, Nouri N, Brooks RB: Frequency and significance of candiduria. Journal of the American Medical Association 1979, 241: 582–584.
Wise GJ, Kozinn PJ, Goldberg P: Amphotericin B as a urologic irrigant in the management of noninvasive candiduria. Journal of Urology 1982, 128: 82–84.
Fong IW, Chang PC, Hinton NA: Fungicidal effect of amphotericin B in urine: in vitro study to assess feasibility of bladder washout for site of candiduria. Antimicrobial Agents and Chemotherapy 1991, 35: 1856–1859.
Pappagianis D, Collins MS, Hector R, Remington J: Development of resistance to amphotericin B inCandida lusitaniae infecting a human. Antimicrobial Agents and Chemotherapy 1979, 16: 123–126.
Fisher JF, Hicks BC, DiPiro JT, Venable J, Fincher RE: Efficacy of a single intravenous dose of amphotericin B in urinary tract infections caused byCandida. Journal of Infectious Diseases 1987, 156: 685–687.
Dermoumi H: In vitro susceptibilities of yeast isolates from the blood to fluconazole and amphotericin B. Chemotherapy 1992, 38: 112–117.
Warnick DW, Burke J, Cope NJ, Johnson EM, Von Fraunhofer NA, Williams EW: Fluconazole resistance inCandida glabrata. Lancet 1988, ii: 1310.
Shiba K, Saito A, Miyahara T: Safety and pharmacokinetics of single and oral intravenous doses of fluconazole in healthy subjects. Clinical Therapeutics 1990, 12: 206–215.
Persons DA, Laughlin M, Tanner D, Perfect J, Gockerman JP, Hathorn JW: Fluconazole andCandida kruseii fungemia. New England Journal of Medicine 1991, 325: 1315.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Occhipinti, D.J., Gubbins, P.O., Schreckenberger, P. et al. Frequency, pathogenicity and microbiologic outcome of non-Candida albicans candiduria. Eur. J. Clin. Microbiol. Infect. Dis. 13, 459–467 (1994). https://doi.org/10.1007/BF01974635
Issue Date:
DOI: https://doi.org/10.1007/BF01974635