- Poster presentation
- Open Access
Candiduria in ICUs: incidence, course and outcome
https://doi.org/10.1186/cc11706
© Juneja et al.; licensee BioMed Central Ltd. 2012
- Published: 14 November 2012
Keywords
- Candida Species
- Antifungal Drug
- Antibiotic Usage
- Predominant Pathogen
- Regional Surveillance
Background
There is a high incidence of candiduria especially in ICU patients. Candiduria may be a sign of a disseminated candida infection and a marker for increased ICU mortality. However, there is always a dilemma regarding which patient to treat, as in a majority of patients it may only be a colonizer. Moreover, the choice of antifungal drug is also controversial due to low urinary concentration of many antifungal drugs. Hence, it becomes imperative to have knowledge of locally prevalent species to guide treatment protocols. The aim of this study was to assess the incidence of candiduria among patients admitted to a medical ICU of an Indian hospital, to perform microbiological characterization and to study their ICU course and outcome.
Methods
Data from 93 consecutive ICU patients with candiduria, admitted during an 18-month period, were obtained retrospectively. Data regarding patient demographics, ICU course and outcome were entered in a pro forma.
Results
Patient demographics, ICU course and outcome
Parameter of interest | Frequency |
|---|---|
Age (years) (± SD) | 59.81 (± 19.5) |
Sex, males (%) | 54 (58.1%) |
Days in ICU before positive culture (± SD) | 10.11 (± 9.8) |
Presence of urinary catheter (%) | 75 (80.6%) |
Days since urinary catheter was present (± SD) | 5.89 (±-3) |
Admission APACHE II score | 17.13 (± 7.8) |
Predicted death rate (%) | 30.36 (± 21.1) |
Previous antimicrobials (%) | 80 (86%) |
Recent hospitalization (%) | 7 (7.5%) |
Neutropenia (%) | 3 (3.2%) |
Nonalbicans infection (%) | 62 (66.7%) |
Blood culture positivity (%) | 18 (19.4%) |
Need for vasopressor support | 52 (55.9%) |
Need for renal replacement therapy | 25 (26.9%) |
Need for mechanical ventilation | 60 (64.5%) |
ICU length of stay (days) | 21.34 (± 23.3) |
Hospital length of stay (days) | 27.38 (± 25.2) |
ICU mortality (%) | 27 (29%) |
Conclusion
There is a high incidence of candiduria in ICU patients, especially among those with indwelling catheters and those on antibiotic therapy. Moreover, in our cohort, an increased proportion of patients with candiduria had noncandida infection, emphasizing the need to have localized regional surveillance studies to identify the locally prevalent candida species and devise antifungal therapy protocols.
Authors’ Affiliations
Copyright
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
