Fungal urinary tract infections in patients at risk.

Fungal urinary tract infection (UTI) represents a high-risk event in severely ill patients. Its increasing incidence in recent years is associated with extensive and prolonged use of broad-spectrum antimicrobial agents, corticosteroids, immunosuppressive and cytotoxic drugs. Other important risk factors comprise higher age, diabetes mellitus, chronic renal failure, hemodialysis, renal transplantation, structural or functional abnormalities of urinary tract with indwelling urinary catheter or nephrostomy. Fifty hospitalized symptomatic patients with funguria of > 10(5) CFU/ml and leucocyturia were analysed for etiology, risk factors and outcome. Candida albicans was isolated in 36 patients, non-albicans Candida species (Candida tropicalis, Candida krusei) and non-Candida yeasts (Blastoschizomyces capitatus) in 14 patients, respectively. All patients were treated with systemic antifungals. In total, 42 patients of 50 (84%) were cured (32/36 with C. albicans and 10/14 with non-C. albicans associated funguria). Systemic antifungal therapy should be considered in high-risk patients with fungal UTI.