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Association Between Candiduria and Candidemia: A Clinical and Molecular Analysis of Cases

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Abstract

The risk of developing candidemia after candiduria is reportedly very low, but it has not been adequately investigated. The aim of this study was to examine the molecular relatedness between Candida strains isolated from adult patients with candidemia and concomitant candiduria in association with the clinical characteristics of the cases. All episodes of candidemia occurring in a tertiary care academic hospital during a 5-year period were recorded prospectively. Patients with episodes of candiduria occurring two weeks preceding to or one week following a positive for Candida blood culture were included in the study. The genotypic relatedness of Candida strains isolated from blood and urine was investigated by pulsed-field gel electrophoresis after digestion with the BssHII restriction endonuclease. We recorded 141 candidemia episodes, occurring in 134 patients. Twelve episodes of candidemia with concomitant candiduria occurred in 11 patients (8% of all candidemias). In six of these episodes, the strains in the blood–urine pairs belonged to different species. In two episodes, the isolates belonged to the same species but were not genetically related, and only in four (2.8% of all candidemias), the strains were related. All four patients were severely ill and had multiple risk factors for candidemia. These findings indicate that in hospitalized patients with candidemia, concomitant candiduria is rare and usually an independent event, confirming previous reports. In the critically ill, however, the existence of genetically related strains in blood and urine appears to be more frequent, with more probable the hematogenous dissemination.

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Acknowledgements

This work was part of the doctoral thesis of I. Anyfantis and has been presented at the 7th Congress on Trends in Medical Mycology (TIMM) 2015, Lisbon, Portugal. We thank Jeannette Lewanowski, a “Leonardo da Vinci” EU-Programme grant recipient from Berlin, Germany, for excellent technical support.

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Authors and Affiliations

  1. Infectious Diseases Research Laboratory, 4th Department of Internal Medicine, University General Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens, Rimini 1, 12462, Athens, Greece

    Maria Drogari-Apiranthitou, Irene Galani & Georgios Petrikkos

  2. 1st Department of Propaedeutic Medicine, “Laiko” General Athens Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece

    Maria Drogari-Apiranthitou, Ioannis Anyfantis, Labrini Kanioura & Georgios Petrikkos

  3. 1st Department of Medicine, “Laiko” General Athens Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece

    Georgios L. Daikos

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  1. Maria Drogari-Apiranthitou
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  2. Ioannis Anyfantis
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  3. Irene Galani
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  4. Labrini Kanioura
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  5. Georgios L. Daikos
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  6. Georgios Petrikkos
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Correspondence to Maria Drogari-Apiranthitou.

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Drogari-Apiranthitou, M., Anyfantis, I., Galani, I. et al. Association Between Candiduria and Candidemia: A Clinical and Molecular Analysis of Cases. Mycopathologia 182, 1045–1052 (2017). https://doi.org/10.1007/s11046-017-0180-2

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  • DOI: https://doi.org/10.1007/s11046-017-0180-2

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