Candida urinary tract infections in adults

Area of Science:

• Mycology
• Infectious Diseases
• Urology

Background:

• Candiduria is frequently observed in hospitalized individuals, often remaining asymptomatic.
• Potential complications include cystitis, pyelonephritis, prostatitis, epididymo-orchitis, and disseminated candidiasis.
• Key risk factors include diabetes mellitus, urinary catheterization, broad-spectrum antibiotic use, urinary obstruction, and intensive care unit (ICU) admission.

Purpose of the Study:

• To review the clinical significance of candiduria.
• To outline risk factors and potential complications.
• To provide guidance on appropriate antifungal therapy.

Main Methods:

• Literature review of candiduria, focusing on diagnosis, risk factors, and treatment.
• Analysis of current clinical guidelines for managing urinary tract infections caused by Candida species.
• Evaluation of antifungal agents for efficacy and urinary concentration.

Main Results:

• Asymptomatic candiduria generally does not require treatment, except in specific populations like neutropenic patients, very low-birth-weight infants, and those undergoing urologic procedures.
• Symptomatic urinary tract infections caused by Candida necessitate antifungal therapy.
• Fluconazole demonstrates high urinary levels and is the recommended first-line treatment for symptomatic candiduria.

Conclusions:

• Management of candiduria depends on patient's symptomatic status and specific risk factors.
• Fluconazole is the primary antifungal agent for symptomatic infections due to its favorable urinary pharmacokinetics.
• Alternative agents like Amphotericin B deoxycholate should be considered for fluconazole-resistant or intolerant cases.