Candiduria in haematologic malignancy patients without a urinary catheter: nothing more than a frailty marker?

Authors

  • Sarah P. Georgiadou,

    1. Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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  • Jeffrey Tarrand,

    1. Department of Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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  • Nikolaos V. Sipsas,

    1. Infectious Diseases Unit, Pathophysiology Department, Laikon General Hospital and Medical School, National and Kapodistrian University of Athens, Athens, Greece
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  • Dimitrios P. Kontoyiannis

    1. Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Dimitrios P. Kontoyiannis, MD, ScD, Department of Infectious Diseases, Infection Control and Employee Health, Unit 402, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA.
Tel.: +(713) 792 6237. Fax: +(713) 745 6839.
E-mail: dkontoyi@mdanderson.org

Summary

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.

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