Cargando…

Frequency and Clinical Features of Candida Bloodstream Infection Originating in the Urinary Tract

The urinary tract is considered an uncommon source of Candida 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...

Descripción completa

Detalles Bibliográficos
Autores principales: Elbaz, Meital, Chikly, Amanda, Meilik, Ronnie, Ben-Ami, Ronen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8878273/
https://www.ncbi.nlm.nih.gov/pubmed/35205877
http://dx.doi.org/10.3390/jof8020123
_version_ 1784658622170529792
author Elbaz, Meital
Chikly, Amanda
Meilik, Ronnie
Ben-Ami, Ronen
author_facet Elbaz, Meital
Chikly, Amanda
Meilik, Ronnie
Ben-Ami, Ronen
author_sort Elbaz, Meital
collection PubMed
description The urinary tract is considered an uncommon source of Candida 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 (p < 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, Candida 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.
format Online
Article
Text
id pubmed-8878273
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-88782732022-02-26 Frequency and Clinical Features of Candida Bloodstream Infection Originating in the Urinary Tract Elbaz, Meital Chikly, Amanda Meilik, Ronnie Ben-Ami, Ronen J Fungi (Basel) Article The urinary tract is considered an uncommon source of Candida 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 (p < 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, Candida 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. MDPI 2022-01-27 /pmc/articles/PMC8878273/ /pubmed/35205877 http://dx.doi.org/10.3390/jof8020123 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Elbaz, Meital
Chikly, Amanda
Meilik, Ronnie
Ben-Ami, Ronen
Frequency and Clinical Features of Candida Bloodstream Infection Originating in the Urinary Tract
title Frequency and Clinical Features of Candida Bloodstream Infection Originating in the Urinary Tract
title_full Frequency and Clinical Features of Candida Bloodstream Infection Originating in the Urinary Tract
title_fullStr Frequency and Clinical Features of Candida Bloodstream Infection Originating in the Urinary Tract
title_full_unstemmed Frequency and Clinical Features of Candida Bloodstream Infection Originating in the Urinary Tract
title_short Frequency and Clinical Features of Candida Bloodstream Infection Originating in the Urinary Tract
title_sort frequency and clinical features of candida bloodstream infection originating in the urinary tract
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8878273/
https://www.ncbi.nlm.nih.gov/pubmed/35205877
http://dx.doi.org/10.3390/jof8020123
work_keys_str_mv AT elbazmeital frequencyandclinicalfeaturesofcandidabloodstreaminfectionoriginatingintheurinarytract
AT chiklyamanda frequencyandclinicalfeaturesofcandidabloodstreaminfectionoriginatingintheurinarytract
AT meilikronnie frequencyandclinicalfeaturesofcandidabloodstreaminfectionoriginatingintheurinarytract
AT benamironen frequencyandclinicalfeaturesofcandidabloodstreaminfectionoriginatingintheurinarytract