MILLER LG, MAN D, LEE C, LEE JY, DISMUKES WE, KAUFFMAN CA; Interscience Conference on Antimicrobial Agents and Chemotherapy (43rd: 2003: Chicago, Ill.).
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2003 Sep 14-17; 43: abstract no. M-2059.
Harbor-UCLA Med. Ctr., Torrance, CA.
BACKGROUND: Candida is the second most common species identified from the urine in U.S. intensive care units. Previous studies demonstrated that some cases of candiduria spontaneously resolve. However, there are few data on factors associated with candiduria resolution. METHODS: Prospective investigation from 10 U.S. medical centers of patients with a urine culture positive for yeast. Our primary outcome was candiduria resolution, defined as a urine culture negative for Candida after study enrollment. We used a repeated measures longitudinal model to identify factors associated with resolution at each follow up culture. These factors included time-independent covariates, such as medical co-morbidities, and time-dependent covariates such as receipt of antifungal antibiotics and urinary catheter changes. RESULTS: Among 860 patients with candiduria, 387 had at least one follow up urine culture. Patients with follow up cultures were more likely than those without to have fever (p=0.08), concomitant infection (p<0.0001), and steroid treatment (p=0.04). In a multivariate model of 1500 follow up cultures, time-dependent predictors of candiduria resolution included: catheter change or removal (p=0.04), percent of past 5 days on antifungal therapy (p=0.001), amphotericin B therapy IV (p<0.0001) and via bladder irrigation (p<0.0001). Age < 16 (p=0.007) and a prior history of urinary tract infections (p=0.06) were the only time-independent predictors. Resolution was not associated with other host factors or Candida species. CONCLUSIONS: Candiduria resolution is associated with medical care related factors such as antifungal therapy and urinary catheter change or removal. Although host factors predict acquisition of candiduria, they had almost no association with candiduria resolution. Further research is needed to identify patients that may benefit from treatment.
Publication Types:
Keywords:
- Amphotericin B
- Antibiotics, Antifungal
- Candida
- Candidiasis
- Humans
- Intensive Care Units
- Longitudinal Studies
- Prospective Studies
- United States
- Urinary Catheterization
- Urinary Tract Infections
Other ID:
UI: 102265121
From Meeting Abstracts