1436. Overtreatment of Candiduria in an Academic Medical Center
Session: Poster Abstract Session: Fungal Infections
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • Candiduria IDSA2013.pdf (333.1 kB)
  • Background: Candiduria is a common finding in hospitalized patients.  In 2009, the Infectious Disease Society of America (IDSA) released treatment guidelines for the management of Candiduria.  Candida is known to commonly represent bladder colonization in asymptomatic patients, especially in the setting of a urinary catheter, and does not necessitate treatment.   We describe overtreatment in one large academic center.

     Methods: We conducted a retrospective study of patients with candiduria at a single academic medical center in Chicago, IL from March 2009 to March 2010.   Data was collected for presence of indwelling catheter, symptoms, pyuria, Candida species, colony count, co-morbidities, and whether Infectious Disease consultation was obtained.  Patients with neutropenia or other immunosuppression, bone marrow or solid organ transplantation, pregnancy or recent urologic procedure were excluded.  Treatment was deemed appropriate for patients with symptomatic infection.  Data was analyzed using SPSS.

    Results:  149 patients were included in the study with a total of 222 episodes of Candiduria (C. albicans 61.4%, C. glabrata 14.1%, C. tropicalis 6.6%, C. parapsilosis 3.7%, C. krusei 3.3%, C. lusitaniae 2.5%, C. kefyr 0.4%).  The mean age was 64 years and 37% were males.  62 episodes (28%) of candiduria were treated with antifungal agents, of which only 33% were appropriately treated based on IDSA guidelines.  Presence of symptoms (p<0.0001), pyuria (p=0.02) and foley catheter (p=0.001) were all associated with initiation of treatment. 

    Conclusion: Based on IDSA recommendations, treatment of asymptomatic Candiduria in a normal host is not indicated.  Despite this, overtreatment occurred commonly at our institution.  Presence of symptoms, foley catheter and pyuria were risk factors for increased rates of therapy.

    Marjorie Conant, MD1, Rex Lim, MD2, Kamaljit Singh, MD1, Caroline J. Thurlow, MD1, Christopher Crank, PharmD,1 and Laurie Proia, MD1, (1)Infectious Disease, Rush University Medical Center, Chicago, IL, (2)Internal Medicine, Rush University Medical Center, Chicago, IL

    Disclosures:

    M. Conant, None

    R. Lim, None

    K. Singh, None

    C. J. Thurlow, None

    C. Crank, None

    L. Proia, None

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