CANDIDEMIA FROM A URINARY-TRACT SOURCE - MICROBIOLOGICAL ASPECTS AND CLINICAL-SIGNIFICANCE

Twenty-six cases of candidemia associated with a well-defined urinary tract source were retrospectively identified and reviewed. Urinary tra ct abnormalities were present in 23 of 26 patients (88%), 19 (73%) of whom had urinary tract obstruction. Nineteen patients had undergone ur inary tract procedures before the onset of candidemia. Episodes of can didemia were brief and low-grade in intensity (median duration, 1 day; median colony count, 1.5 cfu/10 mL of blood). Only eight patients (31 %) received greater-than-or-equal-to 500 mg of amphotericin B. There w ere five in-hospital deaths (19%); two of these deaths were attributed to candidiasis. No late complications of candidemia were documented f or the surviving patients. Patients with urologic pathology and candid uria who undergo surgery or manipulation of the urinary tract are at s ignificant risk for candidemia, and further studies should examine the issue of administration of prophylaxis to this group.