Candidemia Attributed to a Urinary Tract Source: Retrospective Cohort Study of Risk Factors, Clinical Profiles, Therapeutic Approaches and Outcomes - PubMed
5 hours ago
- #Candidemia
- #Antifungal Therapy
- #Urinary Tract Infection
- Urinary-source candidemia is an uncommon but clinically relevant form of invasive candidiasis, often underrecognized and poorly characterized.
- Retrospective single-center study of adult patients with candidemia attributed to a urinary source between 2019 and 2023.
- Most patients had a nephro-urological history, with frequent chronic kidney disease, obstructive uropathy, indwelling urinary devices, and recent urological procedures.
- Type 2 diabetes was present in 50% of patients, most receiving SGLT2 inhibitors.
- Majority presented with fever and sepsis; urinary symptoms were present in only half of the patients.
- Candida albicans was the most frequent isolate, followed by Candida glabrata and Candida parapsilosis, with high rates of elevated fluconazole MICs.
- Empirical therapy was often discordant with final susceptibility; combination antifungal therapy was used in 26.9% of cases.
- Attributable mortality was 23.1%; independent predictors included type 2 diabetes, Barthel Index < 50, therapeutic failure, and septic shock.
- Early recognition and individualized management are essential to improve outcomes.