Management of candiduria: an interview schedule

Abstract number: P1735

Avkan-Oguz V., Yapar N., Avci M., Mermut G., Pullukcu H., Sacar S., Sayin-Kutlu S., Cetin B., Ertugrul B.

Objectives: Management of candiduria remains controversial, mainly due to uncertainties of clinicians how to diagnose and when to start treatment. In this study we aimed to investigate diagnostic and therapeutic approach of different specialists for candiduria.

Methods: An interview schedule composed of 10 questions on candiduria was applied interactively to 393 clinicians during three months in six different tertiary care hospitals. We separated the questions into two parts. First part was about demographic features, following up of Candida guidelines and the advice of participants for patients who have Candida growth in the first urine culture. Second part consisted of six questions about diagnostic and therapeutic approach. These questions were not asked to participants who did not suggest second urine culture after first positive one. We compared the answers of infectious diseases (ID) specialists with the others (internist, surgeon, and intensivist). The data of each participant were evaluated using the Statistical package for Social Sciences version 11. For statistical analyses chi-square test was used.

Results: Of 393 participants, 88 (22.4%) were ID and 305 (87.6%) were other (199 internists, 79 surgeons, 27 intensivists) specialists. Of the participants, 215 (54.7%) were male, 178 (45.3%) were female and mean age was 34.27±8.4 (24–63). The number of participants diagnosing candiduria more than 20 times in a year was 76 (19.4%). The details of interview are presented in the table. The difference between the compliance of ID and other specialist to the guidelines or literature about diagnosis and starting therapy for candiduria was statistically significant. First choice of therapy was amphotericin B for neutropenic patients and fluconazole for nonneutropenic patients.

Conclusion: The ID specialists displayed a more proactive and consistent approach to Candiduria treatment than the other specialists. This approach was especially observed in the high-risk patient group and also in utilising the second urinary culture. Accordingly, the above mentioned results, point to a room for improvement in the management of candiduria, aiming for a consensus.

Table: The approach of Infectious Diseases (ID) and other specialists to candiduria