Prospective multicenter surveillance study of funguria in hospitalized patients

Although fungal urinary tract infections are an increasing nosocomial probl em, the significance of funguria is still not clear. This multicenter prosp ective surveillance study of 861 patients was undertaken to define the epid emiology, management, and outcomes of funguria. Diabetes mellitus was prese nt in 39% of patients, urinary tract abnormalities in 37.7%, and malignancy in 22.2%; only 10.9% had no underlying illnesses. Concomitant nonfungal in fections were present in 85%, 90% had received antimicrobial agents, and 83 .2% had urinary tract drainage devices. Candida albicans was found in 51.8% of patients and Candida glabrata in 15.6%. Microbiological and clinical ou tcomes were documented for 530 (61.6%) of the 861 patients. No specific the rapy for funguria was given to 155 patients, and the yeast cleared from the urine of 117 (75.5%) of them, Of the 116 patients who had a catheter remov ed as the only treatment, the funguria cleared in 41 (35.3%). Antifungal th erapy was given to 259 patients, eradicating funguria in 130 (50.2%). The r ate of eradication with fluconazole was 45.5%, and with amphotericin B blad der irrigation it was 54.4%. Only 7 patients (1.3%) had documented candidem ia. The mortality rate was 19.8%, reflecting the multiple serious underlyin g illnesses found in these patients with funguria.