Candida infections urinary

The urinary pathogens in complicated or nosocomial infections may include E. coli, which accounts for less than 50% of these infections, Proteus spp., Klebsiella pneumoniae, Enterobacter spp., Pseudomonas aeruginosa, staphylococci, and enterococci. Candida spp. have become common causes of urinary infection in the critically ill and chronically catheterized patient. 

Flucytosine is used with amphotericin for treating certain systemic fungal infections, in particular for treating subcutaneous chromobastomycosis. It is used intensively for treating systemic infections of the urinary tract that are caused by various strains of Candida. Synonyms of this drag are ancobon, ancotil, and others. 

In the treatment of fungal meningitis or Candida urinary bladder infections, IV infusion alone is inadequate. It must be supplemented with intrathecal administration or bladder irrigation. 

Fluconazole is very effective in the treatment of infections with most Candida spp. Thrush in the end-stage AIDS patient, often refractory to nystatin, clotrimazole, and ketoconazole, can usually be suppressed with oral fluconazole. AIDS patients with esophageal candidiasis also usually respond to fluconazole. A single 150-mg dose has been shown to be effective treatment for vaginal candidiasis. A 3-day course of oral fluconazole is effective treatment for Candida urinary tract infection and is more convenient than amphotericin B bladder irrigation. Preliminary findings suggest that Candida endophthalmitis can be successfully treated with fluconazole. Stable nonneutropenic patients with candidemia can be adequately treated with fluconazole, but unstable, immunosuppressed patients should initially receive... 

Staphylococus aureus infections may arise from the urinary tract, but they are more commonly a result of bacteremia producing metastatic abscesses in the kidney. Candida spp. are common causes of UTI in the critically ill and chronically catheterized patient. 

Kava has been used traditionally as an antibacterial in the treatment of urinary tract infections (Locher et al., 1995) however, no clinical trials have established that it is truly effective. Kava extracts were not able to inhibit growth of Candida, Pseudomonas, E. coli, Streptococcus pyogenes, or Staphylococcus aureus (Locher et al., 1995). 

Flucytosine (5 FC, 5-fluorocytosine) is indicated in the treatment of septicemia, endocarditis, and urinary tract infection (Candida), and in meningitis and pulmonary infections (Cryptococcus). Flucytosine, which usually is used in combination with amphotericin B, has activity against Candida and Cryptococcus in both in vivo and in vitro systems. Flucytosine is absorbed well, distributed throughout the body. 

Methods - A standardized procedure for vitro susceptibility testing with 5-fluorocytoslne (Ancobon) which permitted both more accurate and more reproducible results was described.5 Two new experimental in vivo models were reported one dealt with cladosporiosls in mice treated with 5-fluoro-cytosine and the second with experimental urinary tract infections in rats caused by Candida albicans. In the former model, 5-fluorocytosine protected experimentally Infected animals against cerebral disease caused by Cladosporium tricholdes but did not clear the tissues of infection in the latter model, infections due to . albicans were treated successfully with amphotericin B, and the model appears useful in the study of anticandldal agents. 

Infectious complications persist as a major cause of death, especially within the first year of heart transplantation (Hosenpud et al. 2000). Within the first month of transplantation, infections are usually of nosocomial bacterial origin, including Pseudomonas aeruginosa. Staphylococcus aureus. Enterococci, and Enterobacteriaceae. These organisms can cause pneumonia, urinary tract and wound infections. Later infections are commonly caused by viruses and opportunistic fungi (e.g., Pneumocystis, Candida, and Aspergillus) (Miniati and Robbin 2002). 

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