Occurrence of candiduria in a population of chronically catheterized patients with spinal cord injury

Study design: Prospective data collection. Objectives: To evaluate occurrence and characteristics of candiduria in a population of individuals with spinal cord injury (SCI) or multiple sclerosis (MS) and chronic catheter usage. Candiduria, or presence of Candida species in the urine, is a common clinical problem. It is most frequently seen in patients with indwelling urinary catheters. Many patients have these catheters in place chronically. Previous studies have shown that despite therapy, most patients with candiduria will develop the infection again and that complications such as invasive candidiasis are rare. However, there are no studies that specifically examine the role of candiduria in patients with SCI and long-term catheter use. Setting: Inpatients and outpatients in a US Veterans Affairs spinal cord injury center. Methods: Urinalysis, culture, patient demographic and clinical characteristics through chart review. Results: Of 100 total patients, 52 had paraplegia, 45 tetraplegia and 3 MS. Overall, 17 (17%) patients had candiduria, which was observed in urine culture. Antibiotic use was associated with an increased risk of developing candiduria. Indwelling catheter (urethral or suprapubic) usage was also significantly associated with candiduria; only one person on intermittent catheterization developed candiduria, which was not associated with adverse clinical outcomes. Conclusions: Antibiotic usage and indwelling catheterization were associated with candiduria. No participant in our study population developed invasive candidiasis, and persistence of candiduria was not frequent. Spinal Cord (2010) 48, 51-54; doi:10.1038/sc.2009.81; published online 7 July 2009