Bloodstream Infection-Causing 'Candida' Urinary Tract Infections Increase Sixfold in 10 Years with High Fatality Rate

Gangnam Severance Professors Jeong Seok-hoon and Choi Min-hyuk Team
20-40% Mortality Rate in Secondary Bloodstream Infection from Urinary Tract Infection
Aging Population and Urinary Catheter Use Cause Pathogen Diversification
Attention Needed for Candida and Staphylococcus aureus

Professor Seok-Hoon Jeong (left) and Professor Min-Hyuk Choi, Department of Laboratory Medicine, Gangnam Severance Hospital.

[Asia Economy Reporter Lee Gwan-ju] A recent study has revealed a sharp increase in the proportion of urinary tract infections caused by Candida species over the past decade. The main factors analyzed were aging and the increased frequency of using urinary catheters (tube-shaped medical consumables). In particular, Candida urinary tract infections were found to have a higher likelihood of leading to secondary bloodstream infections with high mortality compared to infections caused by other pathogens.

The research team led by Professors Jeong Seok-hoon and Choi Min-hyuk from the Department of Laboratory Medicine at Yonsei University Gangnam Severance Hospital conducted a study on the impact of microorganisms causing urinary tract infections on the progression to secondary bloodstream infections and confirmed these findings on the 24th.

Urinary tract infections are one of the common infectious diseases, referring to the invasion of microorganisms into the urethra, bladder, ureters, prostate, etc., causing inflammatory responses. Most infections are caused by intestinal bacteria, but depending on the patient's age, gender, and use of urinary catheters, infections can also be caused by other microorganisms. Usually, the prognosis is good, but if it progresses to secondary bloodstream infection, the mortality rate reaches 20-40%. Until now, only patient factors causing urinary tract-associated bloodstream infections have been analyzed, and evaluation and analysis of causative microorganisms had not been conducted.

The research team used Yonsei University's medical data platform 'SCRAP2.0' to investigate various risk factors such as patient age, gender, underlying diseases, and treatment records including urinary tract catheters for 84,406 patients diagnosed with urinary tract infections at Severance Hospital and Gangnam Severance Hospital from 2011 to last year.

Annual changes in the proportion of microorganisms causing urinary tract infections. [Source=Gangnam Severance Hospital]

As a result, while the relative incidence of urinary tract infections caused by Escherichia coli decreased, urinary tract infections caused by Candida species increased more than sixfold from 2.3% in 2011 to 14.4% in 2021. Additionally, urinary tract infections caused by Candida species and Staphylococcus aureus were associated with a high progression rate to secondary bloodstream infections and high mortality. Among 5,137 patients whose urinary tract infections progressed to bloodstream infections, elderly patients aged 65 and older (62.2%) and urinary catheter users (60.8%) accounted for a high proportion.

Professor Jeong stated, "With aging and increased severity among patients, the frequency of urinary catheter use has increased, leading to a rise in urinary tract infections caused by microorganisms other than Escherichia coli. Since these causative pathogens can result in fatal outcomes, appropriate measures and responses are necessary in medical settings."

This study was published in the international academic journal 'Journal of Infection.'

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