Management of Asymptomatic Yeast in Urine for Patients with Foley Catheters
Understanding Candiduria in Catheterized Patients
- Candiduria (yeast in urine) in patients with indwelling catheters is most commonly a sign of colonization rather than infection and is generally a benign finding 3
- Candida is one of the most frequently isolated organisms from urine in surgical intensive care units 3
Recommended Management Approach
- Asymptomatic candiduria in non-neutropenic catheterized patients should not be treated with antifungal agents 2, 3
- Consider catheter removal or replacement if medically appropriate, which may result in clearance of candiduria in approximately 40% of patients 3
Special Populations Requiring Consideration for Treatment
- Treatment may be warranted despite lack of symptoms in neutropenic patients 3
- Treatment may be warranted despite lack of symptoms in critically ill patients in intensive care units 3
- Treatment may be warranted despite lack of symptoms in low birth weight infants 3
- Treatment may be warranted despite lack of symptoms in transplant recipients 3
- Treatment may be warranted despite lack of symptoms in patients scheduled for urologic procedures with anticipated mucosal bleeding 4
Rationale for Non-Treatment
- A placebo-controlled trial showed that while fluconazole hastened the time to negative urine culture, the frequency of negative cultures 2 weeks after therapy was the same in both treatment and placebo groups 3
- Inappropriate antimicrobial therapy for asymptomatic candiduria may select for resistant organisms 3
Monitoring Recommendations
- Signs and symptoms warranting treatment include fever without another identified source 2
Prevention Strategies
- Maintain a closed drainage system 5