Abstract

ABSTRACT: BACKGROUND: Fungal urinary tract infections are an increasing problem in hospitalized patients. There are specific criteria for evaluating urinary tract infections caused by bacteria.There are also specific guidelines for prevention of catheter associated bacteruria. No such criteria or recommendations are available for fungal urinary tract infections. OBJECTIVE: To evaluate the incidence of catheter associated fungal infection among all patients with catheter associated urinary tract infection and its risk factors. MATERIALS AND METHODS: From January 2009 to March 2011 (72) patients with indwelling urinary catheter for different indications with significant pyuria presented to urologic department at Al-Ramadi teaching hospital were included in this prospective study, all patients were subjected to urine culture for bacteria and fungi. The following information was obtained: age, sex, antibiotic therapy, immunosuppressive therapy, duration of catheterization and the presence of diabetes mellitus. The type of growth whether bacterial or fungal was noted. The age of patients ranges from 2 to 70 years. RESULTS: The age of patients ranged from 2 to 70 years (mean 34.6). Of 72 patients, 12 had diabetes mellitus, 18 patients were on long term antibiotic use and 15 patients on immunosupressants. Bacterial infection accounted for 70.9% of catheter associated urinary infection with E. coli is the most commonly isolated organism(41.6%), fungal infection accounted for 16.6% and mixed fungal and bacterial infection account for 12.5.Risk factors among patients with fungal infection were diabetes mellitus (47.6%), long term antibiotic use (42.8%) , immunosuppressive therapy (9.5%), and prolonged duration of catheterization (85.7%). CONCLUSION: Fungal infection constitutes a significant proportion of all catheter associated urinary tract infection and diabetes mellitus, long term antibiotic use, immunosuppressive therapy, and prolonged duration of catheterization are the most common risk factors.