TY - JOUR
T1 - Prospective multicenter surveillance study of funguria in hospitalized patients
AU - Kauffman, Carol A.
AU - Vazquez, José A.
AU - Sobel, Jack D.
AU - Gallis, Harry A.
AU - McKinsey, David S.
AU - Karchmer, A. W.
AU - Sugar, Alan M.
AU - Sharkey, Patricia Kay
AU - Wise, Gilbert J.
AU - Mangi, Richard
AU - Mosher, Ann
AU - Lee, Jeannette Y.
AU - Dismukes, William E.
N1 - Funding Information:
Received 6 January 1999; revised 29 June 1999; electronically published 6 January 2000. Financial support: This study was supported by a grant from Pfizer, Inc., and by NIAID contract no. N01-AI-65296. a Present affiliations: Carolinas Medical Center, Charlotte, NC (H.A.G.); Allergy, Arthritis, and Infectious Diseases Associates, Hamden, CT (R.M.). Reprints or correspondence: Dr. Carol A. Kauffman, Veterans Affairs Medical Center, 2215 Fuller Rd., Ann Arbor, MI 48105 (ckauff@umich .edu).
PY - 2000
Y1 - 2000
N2 - 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.
AB - 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.
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U2 - 10.1086/313583
DO - 10.1086/313583
M3 - Article
C2 - 10619726
AN - SCOPUS:0033980656
SN - 1058-4838
VL - 30
SP - 14
EP - 18
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 1
ER -