Prospective Multicenter Surveillance Study of Funguria in Hospitalized Patients

Kauffman, C. A.; Vazquez, J. A.; Sobel, J. D.; Gallis, H. A.; McKinsey, D. S.; Karchmer, A. W.; Sugar, A. M.; Sharkey, P. K.; Wise, G. J.; Mangi, R.; Mosher, A.; Lee, J. Y.; Dismukes, W. E.; National Institute for Allergy and Infectious Diseases (NIAID) Mycoses Study Group

doi:10.1086/313583

Cited by 484Antifungal resistance and susceptibilityUrinary Tract Infections ManagementOcular Infections and Treatments

Prospective Multicenter Surveillance Study of Funguria in Hospitalized Patients

Kauffman, C. A., Vazquez, J. A., Sobel, J. D., Gallis, H. A., McKinsey, D. S., Karchmer, A. W., Sugar, A. M., Sharkey, P. K. +6 more·2000·Clinical Infectious Diseases

DOI 10.1086/313583

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Abstract

Although fungal urinary tract infections are an increasing nosocomial problem, the significance of funguria is still not clear. This multicenter prospective surveillance study of 861 patients was undertaken to define the epidemiology, management, and outcomes of funguria. Diabetes mellitus was present in 39% of patients, urinary tract abnormalities in 37.7%, and malignancy in 22.2%; only 10.9% had no underlying illnesses. Concomitant nonfungal infections 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 outcomes were documented for 530 (61.6%) of the 861 patients. No specific therapy 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 removed as the only treatment, the funguria cleared in 41 (35.3%). Antifungal therapy was given to 259 patients, eradicating funguria in 130 (50.2%). The rate of eradication with fluconazole was 45.5%, and with amphotericin B bladder irrigation it was 54.4%. Only 7 patients (1.3%) had documented candidemia. The mortality rate was 19.8%, reflecting the multiple serious underlying illnesses found in these patients with funguria.

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The minimal utility of antifungal therapy against urinary candidiasis is supported by a recent large observational study.
“The minimal utility of antifungal therapy against urinary candidiasis is also supported by a recent large observational study [169].”
From Guidelines for Treatment of Candidiasis (2004) · cites this paper as [169]

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Authors: Kauffman, C. A., Vazquez, J. A., Sobel, J. D., Gallis, H. A., McKinsey, D. S., Karchmer, A. W., Sugar, A. M., Sharkey, P. K., Wise, G. J., Mangi, R., Mosher, A., Lee, J. Y., Dismukes, W. E., & National Institute for Allergy and Infectious Diseases (NIAID) Mycoses Study Group
Affiliations: University of Michigan (US)
Wayne State University (US)
Duke Medical Center (US)
Beth Israel Deaconess Medical Center (US)
Boston University (US)
The University of Texas at San Antonio Health Science Center (US)
Maimonides Medical Center (US)
University of Alabama (US)
Corresponding author: Kauffman, C. A.
ORCID: Sobel, J. D.
Karchmer, A. W.
Lee, J. Y.
Venue: Clinical Infectious Diseases
Publisher: Oxford University Press (OUP)
Published: 2000-01-01
Volume: 30
Issue: 1
Pages: 14-18
ISSN: 1058-4838 (ISSN-L)
1537-6591
DOI: 10.1086/313583
OpenAlex: W2131468549
Cited by: 483
References: 17
Citations by year: 2026: 10 · 2025: 11 · 2024: 10 · 2023: 16 · 2022: 22 · 2021: 25 · 2020: 12 · 2019: 25 · 2018: 20 · 2017: 22 · 2016: 18 · 2015: 25 · 2014: 19 · 2013: 19 · 2012: 15
FWCI: 14.31
Type: journal article
Language: en
Open access: closed
Locations: Clinical Infectious Diseases (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (n01ai065296-009)
National Institute of Allergy and Infectious Diseases (N01AI65296)
Topics: Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
Health Sciences › Medicine › Epidemiology › Urinary Tract Infections Management
Health Sciences › Medicine › Ophthalmology › Ocular Infections and Treatments
Keywords: funguria, fungal urinary tract infection, nosocomial infections, Candida albicans, Candida glabrata, urinary catheter, antifungal therapy, fluconazole, candidemia, mortality, diabetes mellitus, underlying disease
MeSH terms: Aged, Aged, 80 and over, Antifungal Agents, Candidiasis, Catheterization, Cross Infection, Female, Hospitalization, Humans, Male, Middle Aged, Mycoses, Population Surveillance, Prospective Studies, Risk Factors, Urinary Tract Infections, Urine, Fluconazole, Treatment Outcome

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Prospective Multicenter Surveillance Study of Funguria in Hospitalized Patients

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