Risk factors for nosocomial candiduria

To investigate the risk factors and the Candida species that cause candiduria in hospitalized patients via a case-control study.

We evaluated the results of the urine analysis of the specimens sent to the laboratories of Central Microbiology and the Department of Clinical Bacteriology and Infectious Diseases of Selcuk University Medical School, Konya, Turkey between January and December 2004. The urinary specimens, sent from hospitalized patients, obtained within 72 hours were evaluated. A total of 51 patients above 17 years of age, without any bacterial growth in urine specimens, with fever above 38 degrees celcius and pyuria were included in this study. A control group of 153 patients without any bacterial growth at 72 hours after hospitalization was present. The average age of the patients, the hospitalization period, and clinics resemble each other in the 2 groups.

Risk for candiduria was increased by 4 folds (p=0.001; OR=4.020) in abdominal surgery, by 1.4 folds (p=0.335; OR:1.478) in corticosteroid and immune suppressive therapies and by 12 folds (p=0.000; OR=12.408) in urinary catheterization, antibiotic use increased the risk of candiduria by 6 folds (p=0.000; OR=6.00). The risk of candiduria was higher by 2 folds in diabetes mellitus patients than in the controls (p=0.044; OR=2.002).

Candida albicans (68.62%) was the most commonly isolated agent in candiduria patients. We should decrease the use of urinary catheters and avoid excess use of antibiotics as much as possible in hospitalized patients.