scholarly journals High prevalence of asymptomatic nosocomial candiduria due to Candida glabrata among hospitalized patients with heart failure: a matter of some concern?

2021 ◽  
Author(s):  
Seyed Reza Aghili ◽  
Mahdi Abastabar ◽  
Ameneh Soleimani ◽  
Iman Haghani ◽  
Soheil Azizi
Keyword(s):  
Heart Failure ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Candida Species ◽  
Candida Glabrata ◽  
Antifungal Susceptibility ◽  
Hospitalized Patients ◽  
Patients With Heart Failure ◽  
High Prevalence

Background and Purpose: Heart failure is a leading cause of hospitalization, and asymptomatic candiduria is common in hospitalized patients with low morbidity. However, in most patients, it is resolved spontaneously on the removal of the catheter. Despite the publication of guidelines, there are still controversies over the diagnosis and management of candiduria. However, in hospitalized patients with heart failure, the decision to treat candiduria is especially important since the nosocomial infections are associated with an increase in morbidity, mortality, length of hospital stay, and healthcare costs. Some species of Candida, such as Candida glabrata, are increasingly resistant to the first-line and second-line antifungal medications. The present study aimed to investigate the incidence of asymptomatic Candida urinary tract infection due to C. glabrata and antifungal susceptibility of Candida isolates in hospitalized patients with heart failure. Materials and Methods: In total, 305 hospitalized patients with heart failure were studied to identify asymptomatic nosocomial candiduria during 2016-17 in one private hospital in the north of Iran. The Sabouraud’s dextrose agar culture plates with a colony count of >104 colony-forming unit/ml of urine sample were considered as Candida urinary tract infection. Candida species were identified based on the morphology of CHROMagar Candida (manufactured by CHROMagar, France) and PCR-RFLP method with MspI restriction enzyme. Antifungal susceptibility testing of the isolates was performed using five mediations, including itraconazole, voriconazole, fluconazole, amphotericin B, and caspofungin by broth microdilution method according to CLSI M27-S4. Results: In this study, the rate of asymptomatic Candida urinary tract infection was 18.8%, which was more common in people above 51 years old and females (70%). In addition to the urinary and intravascular catheter, the occurrence of candiduria in hospitalized patients had significant relationships with a history of surgical intervention, diastolic heart failure, and use of systemic antibiotics (P>0.05). Among Candida spp., non-albicans Candida species was the most common infectious agent (59.7%). Moreover, C. glabrata (n=27, 40.3%) (alone or with other species) and Candida albicans (n=27, 40.3%) were the most common agents isolated in Candida urinary tract infection. Based on the results of the in vitro susceptibility test, the C. glabrata isolates were 15%, 59%, 70%, 74%, and 85% susceptible to caspofungin, amphotericin B, itraconazole, voriconazole, and fluconazole, respectively. Conclusion: According to the findings, there was a high prevalence of asymptomatic Candida urinary tract infection in hospitalized patients with heart failure. Besides, it was suggested that there was a shift towards non-albicans Candida, especially C. glabrata, in these patients. Therefore, asymptomatic candiduria in hospitalized patients with heart failure should be considered significant. Furthermore, the identification of Candida species along with antifungal susceptibility is essential and helps the clinicians to select the appropriate antifungal agent for better management of such cases.

scholarly journals Candiduria in Hospitalized Patients and Identification of Isolat-ed Candida Species by Morphological and Molecular Methods in Ilam, Iran

2019 ◽  
Author(s):  
Afagh FAZELI ◽  
Parivash KORDBACHEH ◽  
Ali NAZARI ◽  
Roshanak DAIE GHAZVINI ◽  
Hossein MIRHENDI ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Candida Species ◽  
Upper Urinary Tract ◽  
Hospitalized Patients ◽  
Molecular Methods ◽  
Fungal Colonization ◽  
Cross Sectional ◽  
Tract Infections

Background: Candiduria in hospitalized patients may represent contamination, colonization, or urinary tract infections. On the other hand, candidemia and upper urinary tract infection could be the complications of candiduria. The aim of this study was to determine candiduria in hospitalized patients and identify isolated Candida species by conventional and molecular methods. Methods: This cross-sectional study was conducted on hospitalized patients in Imam Khomeini and Mostafa Khomeini hospitals in Ilam, western Iran from Jan to Dec 2016. Urine samples of hospitalized patients were collected during a period of 4 months for diagnosis of candiduria. Primary identification was done by conventional methods. PCR profile was carried out using phenol-chloroform method and confirmed using restriction fragment length polymorphism (PCR-RFLP) technique by MspI restriction enzyme. Results: Candiduria was diagnosed in 18 (9.2%) cases from a total of 195 patients. Isolated yeasts were identified as C. albicans (n: 13), C. glabrata (n: 5), and C. parapsilosis (n: 1) in the one case both C. albicans and C. glabrata were isolated from a urine sample. Conclusion: Candida urinary tract infection is becoming increasingly common in hospitalized patients but, differentiation fungal colonization from infection and identification of etiologic agents for optimal treatment is necessary.  

Ultrasonography in the Radiologic Evaluation of Children With Urinary Tract Infection

PEDIATRICS ◽  
1986 ◽  
Vol 78 (1) ◽  
pp. 58-64 ◽  
Author(s):  
Uri Alon ◽  
Menucha Pery ◽  
Giora Davidai ◽  
Moshe Berant
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Hospitalized Patients ◽  
Voiding Cystourethrography ◽  
Urinary System ◽  
Intravenous Pyelography ◽  
Early Screening ◽  
Radiologic Evaluation ◽  
Radiologic Workup

A prospective blind study comparing the findings of ultrasonography, intravenous pyelography, and voiding cystourethrography was conducted on 81 patients to examine the place of ultrasonography in the initial radiologic evaluation of children with urinary tract infection. The patients' mean age was 4.8 years; 15 were male. Forty-eight were inpatients (mean age, 3.2 years) and 33 were outpatients (mean age, 7.2 years). In 29 patients (35.8%) abnormality of the urinary system was detected by one or more of the three imaging procedures; 21 were inpatients and eight were outpatients. The most frequent finding was vesicoureteral reflux, occurring in 62.1% of the pathologic cases. The findings at ultrasonography correlated well with those of intravenous pyelography in 73 of the 81 studies (90.1%), but they failed to demonstrate double collecting systems and several of the minor changes. However, ultrasonography in combination with cystourethrography identified all patients who had abnormal urinary systems, except for two children with negligible findings. Moreover, ultrasonography and cystourethrography together identified all 11 patients, nine of them inpatients, in whom surgical treatment was indicated. It is concluded that ultrasonography can successfully replace intravenous pyelography as a screening imaging procedure for the urinary system, but because of the superiority of intravenous pyelography in the detection of some types of lesions, intravenous pyelography will be required whenever ultrasonography or cystourethrography results are abnormal. Accordingly, and in view of the differences in the frequency and severity of pathologic findings between outpatients and hospitalized patients, the following protocol is suggested for the radiologic evaluation of children with urinary tract infection: For outpatients, cystourethrography can be performed 4 to 6 weeks after cessation of antibiotic therapy. If the study is normal, ultrasonography can be done; if this is also normal, no further radiologic workup is needed. Only when cystourethrography or ultrasonography findings are abnormal is intravenous pyelography also indicated. For hospitalized patients, especially young children, ultrasonography can be used as the early screening procedure, within two to four days after the diagnosis of urinary tract infection. If the results are normal, cystourethrography can follow after 4 to 6 weeks; if abnormal, cystourethrography can be performed after ten to 14 days. Here, too, intravenous pyelography is needed only when ultrasonography and/or cystourethrography results are abnormal.

High prevalence of urinary tract infection in pregnants in Amazonas

2018 ◽  
Vol 29 (2) ◽  
pp. 37-43
Author(s):  
Giane Zupellari dos Santos-Melo ◽  
Joscilane Santos de Souza ◽  
Gisele Torrente ◽  
Elielza Guerreiro Menezes
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
High Prevalence

Urinary Tract Infection in Patients with Multiple Sclerosis: An Overview

2020 ◽  
Author(s):  
Washigton Luiz Gomes de Medeiros Junior ◽  
Caio Cesar Demore ◽  
Larissa Peres Mazaro ◽  
Matheus Fellipe Nascimento de Souza ◽  
Laura Fiuza Parolin ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Mortality Rate ◽  
Tract Infection ◽  
Neurological Complications ◽  
Search Terms ◽  
Group Methods ◽  
High Prevalence ◽  
The Central Nervous System

Introduction: Multiple sclerosis (MS) is a demyelinating, chronic, inflammatory and autoimmune disease of the central nervous system (CNS) with axonal degeneration, presenting a progressive and variable course. MS patients usually have complications, such as bladder dysfunction, presence of urinary symptoms and Urinary Tract infection (UTI), which is one of the three most common non-neurological complications in MS patients. Objective: Analyze the most diverse aspects of UTI in MS patients, focusing on risk factors, prevalence, hospitalization and mortality rates of UTIs in this group. Methods: A non-systematic review of articles published on PubMed in the last 10 years with the search terms "Urinary Tract Infection" AND "Multiple Sclerosis". Discussion: MS patients have a high UTI prevalence, mainly due to the occurrence of urinary disorders in these patients. The most common symptoms of UTI in MS patients are urinary urgency, polyuria, nocturia, urinary retention, and incontinence. Escherichia coli, Pseudomonas aeruginosa, and Klebsiella pneumoniae were the most found organisms and treatment is based on antibiotic therapy. Moreover, UTIs can precipitate outbreaks, worsen the disease, causing more damage and a severe neurological condition deterioration. Therefore, UTIs in this group are associated with a high hospitalizations rate and a high mortality rate. Conclusion: UTI represents a great risk and concern in MS patients. The high prevalence, hospitalization rate and mortality rate of UTI in MS is worrying, such as the cause-consequence relationship between UTIs and the use of corticosteroids in outbreaks. Therefore, it is important to be aware of a UTI in this group to make early diagnoses, adequate management, and new infections prevention. Thus, further studies are needed to thoroughly analyze each nuance of this important comorbidity for MS patients.

scholarly journals Treatment of Candiduria with Micafungin: A Case Series

2007 ◽  
Vol 18 (2) ◽  
pp. 149-150 ◽  
Author(s):  
Danny Lagrotteria ◽  
Coleman Rotstein ◽  
Christine H Lee
Keyword(s):  
Urinary Tract Infection ◽  
Candida Albicans ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Candida Glabrata ◽  
Gradual Increase ◽  
Present Report ◽  
Case Series ◽  
Tract Infections

There has been a gradual increase in the incidence of non-Candida albicans-related nosocomial infections.Candida glabrataurinary tract infections have increased in frequency, and treating these infections can be difficult because the organism may be resistant to fluconazole. A newer antifungal agent, micafungin, which belongs in the class of echinocandins, provides an alternative and effective therapy againstC glabrata. The present report describes three cases ofC glabrata-associated urinary tract infections successfully treated with micafungin. To the authors’ knowledge, this is the first report of successful treatment ofC glabrataand azole-resistantC albicans-associated urinary tract infection with an echinocandin.

scholarly journals Antimicrobial Resistance in Hospitalized Patients with Community Acquired Urinary Tract Infection in Isfahan, Iran

2021 ◽  
Vol 24 (3) ◽  
pp. 187-192
Author(s):  
Sayed Nassereddin Mostafavi ◽  
Soodabeh Rostami ◽  
Yasamin Rezaee Nejad ◽  
Behrooz Ataei ◽  
Sina Mobasherizadeh ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Antimicrobial Resistance ◽  
Tract Infection ◽  
Hospitalized Patients
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