Candidurie nosocomiali: analisi dei fattori di rischio, terapia ed evoluzione micologica. Risultati di una indagine nazionale

The multiple problems associated with the recovery of yeasts from urine specimens induced the Medical Mycology Committee (CoSM) of AMCLI to run a nationwide epidemiologic survey on candiduria in order to evaluate risk factors, involved species, treatment and outcome. Ten hospitals (Bergamo, Como, Crema, Novara,Varese,Ancona, Florence, Pescara, Palermo and Taranto) participated to this study, which was run on a 15-month period (October 1, 2001-December 31, 2002). Overall, 83 Data Forms were collected, regarding patients admitted to Intensive Care Units (45), Surgical (9) and Medical (29) wards. The most common risk factors were: bladder catheter, antibiotic therapy, parenteral nutrition, kidney failure, surgery. Candiduria, mostly asymptomatic, were often associated with fever and bacterial infections. Concurrent candidaemia was detected in 13 patients. Candida albicans was the most frequently recovered species, from both urine and blood, followed by C. glabrata. Other Candida species were occasionally isolated from urine specimens. Specific antifungal treatment was administered to 58% of the patients, mostly using fluconazole. The remaining subjects did not receive antimycotic therapy. Eradication of Candida from urine specimens was observed even without a specific therapy.