Frequency and Clinical Features of <i>Candida</i> Bloodstream Infection Originating in the Urinary Tract
The urinary tract is considered an uncommon source of <i>Candida</i> 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 CBS...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-01-01
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| Series: | Journal of Fungi |
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| Online Access: | https://www.mdpi.com/2309-608X/8/2/123 |
| _version_ | 1797478890947477504 |
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| author | Meital Elbaz Amanda Chikly Ronnie Meilik Ronen Ben-Ami |
| author_facet | Meital Elbaz Amanda Chikly Ronnie Meilik Ronen Ben-Ami |
| author_sort | Meital Elbaz |
| collection | DOAJ |
| description | The urinary tract is considered an uncommon source of <i>Candida</i> 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 (<i>p</i> < 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, <i>Candida</i> 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. |
| first_indexed | 2024-03-09T21:38:03Z |
| format | Article |
| id | doaj.art-3611ff485ee54eb6b0199f6f61d6af27 |
| institution | Directory Open Access Journal |
| issn | 2309-608X |
| language | English |
| last_indexed | 2024-03-09T21:38:03Z |
| publishDate | 2022-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Fungi |
| spelling | doaj.art-3611ff485ee54eb6b0199f6f61d6af272023-11-23T20:37:13ZengMDPI AGJournal of Fungi2309-608X2022-01-018212310.3390/jof8020123Frequency and Clinical Features of <i>Candida</i> Bloodstream Infection Originating in the Urinary TractMeital Elbaz0Amanda Chikly1Ronnie Meilik2Ronen Ben-Ami3Infectious Disease Unit, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, IsraelInfectious Disease Unit, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, IsraelInfectious Disease Unit, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, IsraelThe urinary tract is considered an uncommon source of <i>Candida</i> 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 (<i>p</i> < 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, <i>Candida</i> 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.https://www.mdpi.com/2309-608X/8/2/123candidemiablood stream infectionurinary tract infection |
| spellingShingle | Meital Elbaz Amanda Chikly Ronnie Meilik Ronen Ben-Ami Frequency and Clinical Features of <i>Candida</i> Bloodstream Infection Originating in the Urinary Tract Journal of Fungi candidemia blood stream infection urinary tract infection |
| title | Frequency and Clinical Features of <i>Candida</i> Bloodstream Infection Originating in the Urinary Tract |
| title_full | Frequency and Clinical Features of <i>Candida</i> Bloodstream Infection Originating in the Urinary Tract |
| title_fullStr | Frequency and Clinical Features of <i>Candida</i> Bloodstream Infection Originating in the Urinary Tract |
| title_full_unstemmed | Frequency and Clinical Features of <i>Candida</i> Bloodstream Infection Originating in the Urinary Tract |
| title_short | Frequency and Clinical Features of <i>Candida</i> Bloodstream Infection Originating in the Urinary Tract |
| title_sort | frequency and clinical features of i candida i bloodstream infection originating in the urinary tract |
| topic | candidemia blood stream infection urinary tract infection |
| url | https://www.mdpi.com/2309-608X/8/2/123 |
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