Candida microorganisms frequently exist as saprophytes on the external genitalia or urethra, however, yeast in measurable quantities are found in <1% of clean voided urine specimens. The overall frequency of Candida infections in hospitals has increased by 200% to 300% in the last decade, such that in a general hospital 5% of urine cultures may yield Candida species, and in tertiary-care centers Candida species account for approximately 10% of all urinary isolates. Most positive cultures are isolated or transient findings of little significance and represent colonization rather than true infection, and less than 10% of candidemias are the consequence of candiduria, nevertheless, Candida urinary tract infections have emerged as important nosocomial infections.
The most common pathogenic mechanism of urinary tract infections by Candida spp. Is UTI hematogenous spread (secondary candidiasis of the urinary tract). Primary candidiasis of the urinary tract is almost exclusively nosocomial and occurs mainly in the presence of an indwelling urinary catheter. Urinary obstruction, diabetes mellitus, or prior urinary tract procedures. Occasionally, primary UTI by Candida spp. Can lead to disseminated infection.
The spectrum of candidiasis in the urinary tract ranges from benign colonization with no clinical significance (very common) to urethritis (usually associated with balanitis), asymptomatic cystitis, pyelitis, fungus ball of the ureter, papillary necrosis, or perinephric or renal abscesses.