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. 2022 Jan 27;8(2):123.
doi: 10.3390/jof8020123.

Frequency and Clinical Features of Candida Bloodstream Infection Originating in the Urinary Tract

Meital Elbaz  1 , Amanda Chikly  1 , Ronnie Meilik  2 , Ronen Ben-Ami  1   2
Affiliations

Frequency and Clinical Features of Candida Bloodstream Infection Originating in the Urinary Tract

Meital Elbaz et al. J Fungi (Basel). .

Abstract

The urinary tract is considered an uncommon source of Candida bloodstream infection (CBSI). We aimed to determine the source of CBSI in hospitalized patients, and to compare clinical and microbiological features of CBSI originating in the urinary tract (U-CBSI) and non-urinary CBSI (NU-CBSI). Of 134 patients with CBSI, 28 (20.8%) met criteria for U-CBSI, 34 (25.3%) had vascular catheter-related CBSI and 21 (15.6%) had a gastrointestinal origin. Compared to NU-CBSI patients, patients with U-CBSI were older with higher rates of dementia. Bladder catheterization for urinary retention and insertion of ureteral stents or nephrostomies were risk factors for U-CBSI. Fifty percent of U-CBSI cases occurred within 48 h of hospital admission, versus 16.9% of NU-CBSI (p < 0.0001). The mortality rate was lowest for CBSI originating in the urinary tract and highest for CBSI of undetermined origin. CBSI of undetermined origin remained associated with higher mortality in a Cox regression model that included age, Candida species, Pitt bacteremia score and neutropenia as explanatory variables. U-CBSI may be increasing in frequency, reflecting extensive use of bladder catheters and urologic procedures in elderly debilitated patients. Distinct clinical features are relevant to the diagnosis, treatment and prevention of U-CBSI.

Keywords: blood stream infection; candidemia; urinary tract infection.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Survival analysis by source of candidemia Kaplan–Meier plot comparing the survival of patients with candidemia originating in the urinary tract (urine), central vascular catheter (cvc), gastrointestinal tract (gi) or an undetermined source (unknown). p value was calculated with the log-rank method for the comparison of all groups.
See this image and copyright information in PMC

Comment in

  • Geriatrics.
    Griebling TL. Griebling TL. J Urol. 2023 Feb;209(2):425-427. doi: 10.1097/JU.0000000000003075. Epub 2022 Nov 18. J Urol. 2023. PMID: 36398532 No abstract available.

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