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Candiduria in kidney transplant recipients: Is antifungal therapy useful?
- Source :
-
Mycoses [Mycoses] 2018 May; Vol. 61 (5), pp. 298-304. Date of Electronic Publication: 2018 Feb 19. - Publication Year :
- 2018
-
Abstract
- A French single-centre retrospective study between 2010 and 2014 was undertaken to assess candiduria's incidence in kidney transplant recipients (KTR), and the use and impact of antifungal treatment on outcome. Candiduria was defined as a urine culture with ≥10 <superscript>3</superscript>  cfu/mL of Candida species. Candiduria clearance, severe complications and death rates were estimated by Kaplan-Meier methods and the effect of treatment by Cox models. 52/1223 (4.3%) KTR had ≥1 episode of candiduria, 42 (81%) were females, 18 (35%) had diabetes, with an incidence of 2.3/100 person-year of follow-up. Candiduria was asymptomatic in 51 (98%) patients. Candida glabrata was the most frequent pathogen identified. Overall fungal clearance rate was 89%. Antifungal therapy was initiated in only 14 episodes (12%), according to guidelines. Three patients (6%) developed severe complications in the first 2 weeks after transplantation, and 8 (15%) died. Antifungal treatment had no impact on candiduria clearance (HR, 0.6; 95% CI, 0.3-1.1; P = .10), on recurrence rate (HR, 0.5; 95% CI, 0.1-2.3; P = .41) and on the risk of severe complications or death (HR, 1.1; 95% CI, 0.3-4.8; P = .89). Candiduria is rare and usually asymptomatic among KTR. Candiduria management in the immediate post-transplant period deserves careful attention.<br /> (© 2017 Blackwell Verlag GmbH.)
- Subjects :
- Adult
Aged
Antifungal Agents adverse effects
Candida classification
Candida isolation & purification
Candidiasis complications
Candidiasis mortality
Candidiasis urine
Female
Humans
Incidence
Kidney Transplantation adverse effects
Male
Middle Aged
Proportional Hazards Models
Retrospective Studies
Risk Factors
Treatment Outcome
Urinary Tract Infections microbiology
Urinary Tract Infections mortality
Antifungal Agents therapeutic use
Candida drug effects
Candidiasis drug therapy
Transplant Recipients
Urinary Tract Infections drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1439-0507
- Volume :
- 61
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Mycoses
- Publication Type :
- Academic Journal
- Accession number :
- 29280198
- Full Text :
- https://doi.org/10.1111/myc.12740