Candiduria in the Critically Ill: A Gray Zone for the Microbiologist and Clinician Alike!

Abstract

Diagnosis and management of candiduria in hospitalized patients is often a gray zone for clinicians and microbiologists alike. The presence of Candida in urine could mean anything ranging from contamination and colonization to frank urinary tract infection. This study aims to enhance the understanding of candiduria among critically ill patients admitted in the intensive care unit (ICU). Out of 226 urine samples received in the laboratory from patients admitted in the ICU with an indwelling urinary catheter, 15 were found to have candiduria, prevalence being 6.6%. Various species isolated were Candida tropicalis (40%), Candida albicans (33.33%), Candida lusitaniae (13.33%), Candida parapsilosis (6.66%), and Candida dubliniensis (6.66%). In all patients, candiduria resolved spontaneously upon removal of the catheter. No antifungal was administered, and no concurrent positive blood culture was found in any of these patients. This study emphasizes that simply culturing the organism does not imply clinical significance. Removal or change of catheter must be undertaken once such a report is received from the laboratory.