Candiduria and Fungal Urinary Tract Infections Management
Summary
Candiduria, defined by the presence of Candida species in urine, ranges from asymptomatic colonisation to invasive upper urinary tract infections. It chiefly affects hospitalised and catheterised patients, as well as those with diabetes or immunosuppression. Candida albicans remains the predominant pathogen, but non-albicans species such as C. glabrata, C. tropicalis and the emerging multidrug-resistant C. auris are increasingly reported. Predisposing factors include broad-spectrum antibiotic use, urinary catheterisation and metabolic derangements. Accurate diagnosis demands quantitative culture, careful clinical assessment to distinguish colonisation from true infection and antifungal susceptibility testing to guide therapy. First-line management of symptomatic candiduria typically involves fluconazole for susceptible isolates, with echinocandins or amphotericin B reserved for resistant strains. Although a 14-day treatment course has been standard, recent evidence points to the potential of shorter regimens without compromising efficacy. Preventive measures focus on minimising indwelling devices, optimising glycaemic control and implementing antifungal stewardship. Innovations in rapid diagnostics and novel antifungal delivery—such as bladder irrigations and combination therapies—are under evaluation to curb relapse rates, combat resistance and lower healthcare burdens worldwide.
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Candiduria and Fungal Urinary Tract Infections Management publication trend
The graph below shows the total number of articles in candiduria and fungal urinary tract infections management across all publications each year (not limited to Nature Index journals).
Technical terms
Candiduria: Abnormal presence of Candida species in urine, indicating colonisation or infection of the urinary tract.
Fungistatic and fungicidal: Descriptions of antifungal agents that inhibit fungal growth versus those that kill fungal cells outright.
Antifungal susceptibility testing: Laboratory methods, such as broth microdilution, to determine the sensitivity of fungal isolates to antifungal drugs.
Biofilm: A structured community of microbial cells enclosed in a self-produced extracellular matrix, contributing to persistence and drug resistance.
Electrochemical impedance spectroscopy: Analytical technique measuring electrical impedance changes to detect microbial cells or biomarkers in fluid samples.
References
- Again and Again—Survival of Candida albicans in Urine Containing Antifungals. Pharmaceutics (2024).
- Hospitalized COVID-19 Patients with Urinary Tract Infection in Iran: Candida Species Distribution and Antifungal Susceptibility Patterns. Antibiotics (2024).
- Evaluation of shorter versus longer antifungal treatment durations for Candida spp. urinary tract infections among hospitalized adults. Antimicrobial Agents and Chemotherapy (2025).
- Rapid detection of Candida albicans in urine by an Electrochemical Impedance Spectroscopy (EIS)-based biosensor. Sensors & Diagnostics (2023).
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