Candiduria and UTI caused by Candida and related species in children
‘Candida’ may be used as a descriptive term as well as a genus name. Some yeasts that were previously considered Candida species have been reclassified and are now considered candida-like and may be reported with a new name (eg Nakaseomyces glabratus, Pichia kudriavzevii)Borman, 2021Keighley, 2021. For a list of commonly encountered Candida and related species and, if applicable, revised species names, see Common Candida and related species, and changes to nomenclature1.
The isolation of Candida and related species from urine is common, particularly in children with indwelling urinary catheters; this finding usually reflects colonisation and rarely leads to disseminated candidiasis.
Most children with asymptomatic candiduria (caused by Candida and related species) do not require antifungal therapy (systemic or local). Only patients at high risk of developing disseminated candidiasis require treatment – seek expert advice.
Seek expert advice to treat candiduria and urinary tract infection (UTI) caused by Candida and related species in children. Consider treating:
- children with neutropenia
- children undergoing urological procedures
- infants of low birth weight
- children with symptoms of a UTI.
Relapse after treatment is common; the risk of candiduria and UTI caused by Candida and related species is increased by use of urinary catheters, urinary stents or nephrostomy tubes – remove these devices if possible.
Consider renal imaging studies to exclude the presence of a fungus ball within the urinary tract in children who have persistent candiduria or neonates with candiduria; if confirmed, surgical removal is strongly recommended.
If a urinary tract source of invasive candidaemia is suspected, see Overview of initial therapy for candidaemia for management advice.