La candidurie en milieu de réanimation : signification et intérêt de la numération des levures dans les urines

Abstract

Justification Candiduria is increasingly frequent among patients admitted to intensive care units but its significance remains unclear. Objectives Search for eventual correlation between quantitative candiduria and known risk factors for invasive candidiasis. Study design Prospective. Patients and methods A four-month study was conducted in 162 patients hospitalized in the intensive care unit for more than 72 hours. All patients underwent a weekly research of candiduria added to sampling from different body sites to determine the Pittet Candida colonization index. Results Candiduria has been proved in 56 cases (34%). It was superior or equal to 10 4 UFC/ml among 28 patients (50%). Candida tropicalis, Candida glabrata and Candida albicans has been isolated in 41, 22 and 20% respectively. All patients had at least one major and two minor risk factors for Candida infection. Six patients (10%) developed invasive candidiasis. The global mortality rate was at 52%. Pittet colonization index was significantly different between patients with candiduria and those with invasive candidiasis ( p = 0.01). There was a statistically significant correlation between candiduria superior or equal to 10 4 UFC/ml and Pittet colonization index superior or equal to 0.5 ( p = 0.01). Conclusion Candiduria superior or equal to 10 4 UFC/ml associated with risk factors may predict invasive candidiasis in critically ill patients.