The risk factors in patients with candiduria associated with candidemia

Kim, Chang Oh; Kim, Myoung Hwan; Shim, Dae Keun; Cho, Jung Ho; Kim, Byoung Keuk; Kim, Chang Nyun; Song, Young Goo; Kim, June Myung

Abstract

BACKGROUND: The early diagnosis of candidemia is critical for the management. The candidemia is known to be associated with 10% of candiduria. But the risk factors in patients with candiduria who are associated with candidemia are not known. We analyzed the risk factors in patients with candiduria who are associated with candidemia.
METHODS
We retrospectively reviewed 164 patients with candiduria in Yonsei Medical Center from January 1998 to December 1998. Candiduria patients were divided into two groups. Candiduria patients without candidemia (Group I, 147 patients) and candiduria patients with candidemia (Group II, 17 patients).
RESULTS
1) The mean age of the patients were 57.5 years in group I and 62.5 years in group II. There were no significant differences in the sex ratio between the two groups. 2) Central venous catheter insertion (53%, 100% in group I, II), hypotension (14%, 59% in group I, II), other associated infections (64%, 100% in group I, II), intensive care (41, 76% in group I, II) and fever (46%, 82% in group I, II) were the very significant risk factors in patients with candiduria who were associated with candidemia. 3) Urinary tract procedure (11%, 88% in group I, II), urinary catheter insertion (63%, 94% in group I, II), thrombocytopenia (17%, 41% in group I, II) and DM (8%, 24% in group I, II) were the significant risk factors of candidemia. 4) Candida colony count (cfu/mL) of urine culture was not a significant risk factor. 5) Mortality rate (27%, 59% in group I, II) was significantly high in patients with candidemia.
CONCLUSION
Central venous catheter insertion, hypotension, other associated infections, intensive care and fever were the very significant risk factors of candidemia in patients with candiduria.