Haptoglobin (HP) polymorphisms influence antioxidant function and coronary artery disease (CAD) susceptibility, showing notable ethnic variations. Comprehensive studies examining both HP phenotypes and serum concentrations in Chinese populations are lacking. The present study investigated associations between HP parameters and CAD risk in a Chinese cohort. The hospital‑based study enrolled 230 patients with CAD, 83 angiography‑defined controls (stenosis ≤40%) and 192 healthy controls. Serum HP concentrations were quantified using an immunoturbidimetric method. HP genotypes were determined using reverse transcription‑quantitative PCR and polyacrylamide gel electrophoresis. Multivariate logistic regression analysis was used to identify CAD predictors and genotype‑stratified analyses assessed HP associations with cardiac function, such as left ventricular ejection fraction (LVEF) and disease severity, as indicated by effected vessel count. Patients with CAD showed higher Hp2‑2 genotype prevalence (54.8 vs. 41.1% in healthy controls; P<0.001) and elevated genotype‑specific serum HP concentrations (HP2‑2, 1.50±0.84 vs. 0.85±0.42 g/l; P<0.001) compared with healthy controls. Serum HP concentration, hypertension, triglyceride concentration and Hp2‑2 phenotype were independently associated with CAD risk, with high‑density lipoprotein‑cholesterol identified as a protective factor. Notably, Hp1‑1 carriers exhibited an inverse HP‑LVEF correlation (r=‑0.607; P=0.010), while Hp2‑2 showed a moderate correlation with cardiac function (r=‑0.249; P=0.013). A significant positive correlation with HP‑vessel count trend also emerged in Hp1‑1 patients (r=0.410, P=0.065). HP concentration was a potent CAD risk biomarker in the investigated populations, with clinical relevance modified by genotype. Hp1‑1 carriers demonstrate particularly strong associations between elevated HP levels and impaired cardiac function. Therefore, implementation of genotype‑stratified HP assessment may enhance CAD risk evaluation in precision medicine approaches.

Vulvovaginal candidiasis (VVC) affects approximately 75

INTRODUCTION:The analysis and identification of Candida in sputum specimens is of significance in clinical settings. The aim of this study was to assess the feasibility of a previously validated rapid method for preparing Candida DNA in conjunction with pretreatment with Sputasol (Aiyan Biotechnology, Shanghai, China) for detecting Candida in sputum specimens. METHODOLOGY:The study included 181 patients with respiratory diseases who were hospitalized at the Bethune International Peace Hospital between 9 and 29 January 2020. Sputum specimens were collected retrospectively, and sputum culture results and related clinical information were extracted from electronic medical records. The sputum samples were pre-treated with Sputasol digest and subjected to rapid DNA sample preparation, and duplex polymerase chain reaction (PCR) for detecting Candida. RESULTS:Out of the 181 sputum specimens, 65 tested positive for Candida through PCR, and 32 were positive through fungal culture. The samples that tested positive through fungal culture were also positive through PCR, and the identified species were completely consistent. Conversely, all samples that tested negative through PCR were also negative through fungal culture. The two assays showed moderate agreement, with a Kappa value of 0.554. The false-positive results of PCR Candida detection may be attributed to antifungal treatment and higher sensitivity. CONCLUSIONS:The rapid Candida DNA sample preparation technique combined with duplex PCR for Candida detection is a sensitive method for identifying Candida in sputum. It is necessary to combine PCR results with comprehensive clinical judgment for deriving conclusions. Further studies are needed to verify its clinical value.

Download This Paper Open PDF in Browser Add Paper to My Library Share: Permalink Using these links will ensure access to this page indefinitely Copy URL Copy DOI

Klebsiella pneumoniae (KP) is the second most prevalent Gram-negative bacterium causing bloodstream infections (BSIs). In recent years, the management of BSIs caused by KP has become increasingly complex due to the emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP). Although numerous studies have explored the risk factors for the development of CRKP-BSIs, the mortality of patients with KP-BSIs, and the molecular epidemiological characteristics of CRKP, the variability in data across different populations, countries, and hospitals has led to inconsistent conclusions. In this single-center retrospective observational study, we utilized logistic regression analyses to identify independent risk factors for CRKP-BSIs and factors associated with mortality in KP-BSI patients. Furthermore, a risk factor-based prediction model was developed. CRKP isolates underwent whole-genome sequencing (WGS), followed by an evaluation of microbiological characteristics, including antimicrobial resistance and virulence genes, as well as epidemiological characteristics and phylogenetic analysis. Our study included a total of 134 patients with KP-BSIs, comprising 50 individuals infected with CRKP and 84 with carbapenem-susceptible Klebsiella pneumoniae (CSKP). The independent risk factors for CRKP-BSIs were identified as gastric catheterization (OR = 9.143; CI = 1.357–61.618; P = 0.023), prior ICU hospitalization (OR = 4.642; CI = 1.312–16.422; P = 0.017), and detection of CRKP in non-blood sites (OR = 8.112; CI = 2.130-30.894; P = 0.002). Multivariate analysis revealed that microbiologic eradication after 6 days (OR = 3.569; CI = 1.119–11.387; P = 0.032), high Pitt bacteremia score (OR = 1.609; CI = 1.226–2.111; P = 0.001), and inappropriate empirical treatment after BSIs (OR = 6.756; CI = 1.922–23.753; P = 0.003) were independent risk factors for the 28-day mortality in KP-BSIs. The prediction model confirmed that microbiologic eradication after 6.5 days and a Pitt bacteremia score of 4.5 or higher were significant predictors of the 28-day mortality. Bioinformatics analysis identified ST11 as the predominant CRKP sequence type, with blaKPC−2 as the most prevalent gene variant. CRKP stains carried multiple plasmid-mediated resistance genes along with some virulence genes. Phylogenetic analysis indicated the presence of nosocomial transmission of ST11 CRKP within the ICU. The analysis of risk factors for developing CRKP-BSIs and the association between KP-BSIs and 28-day mortality, along with the development of a risk factor-based prediction model and the characterization of CRKP strains, enhances clinicians’ understanding of the pathogens responsible for BSIs. This understanding may help in the timely administration of antibiotic therapy for patients with suspected KP-BSIs, potentially improving outcomes.

PURPOSE:This study aimed to develop a double antigen sandwich ELISA (DAgS-ELISA) method for more efficient, accurate, and quantitative detection of total antibodies against Candida albicans enolase1 (CaEno1) for diagnosing invasive candidiasis (IC). METHODS:DAgS-ELISA was developed using recombinant CaEno1 and a monoclonal antibody as the standard. Performance evaluation included limit of detection, accuracy, and repeatability. Dynamic changes in antibody levels against CaEno1 in serum from systemic candidiasis mice were analyzed using DAgS-ELISA. Patient serum samples from IC, Candida colonization, bacterial infections, and healthy controls were analyzed with DAgS-ELISA and indirect ELISA. RESULTS:DAgS-ELISA outperformed indirect ELISA in terms of linear range and test background. In systemic candidiasis mice, a distinctive 'double-peak' pattern in dynamic antibody levels was observed. Additionally, there was a high level of consistency in the positive rates of CaEno1 antibodies detected by both DAgS-ELISA and indirect ELISA. While the positivity rates differed among patient groups, no significant variations in antibody levels were detected among the various positive patient groups. CONCLUSIONS:DAgS-ELISA offers a reliable novel approach for IC diagnosis, enabling rapid, accurate, and quantitative detection of CaEno1 antibodies. Further validation and optimization are needed for its clinical application and effectiveness.

The distribution of Haptoglobin (HP) subtypes differs according to race and geography. It was also confirmed that the serum HP concentration was substantially affected by the HP subtypes. This study aimed to investigate the HP subtypes in northern Chinese and to establish reference intervals for the major HP subtypes using the BN II system. 1195 individuals were included in the study, grouped by haptoglobin subtype, and tested for concentrations by BN II System. Analysis of reference range was performed according to the EP28-A3c guideline. The need to establish reference ranges for subtype, gender, and age groupings was confirmed by the Z-test. The 2.5th and 97.5th percentiles were used as the upper and lower limits of the reference interval, respectively. In the population we investigated, the HP2-2 subtype had the highest proportion, accounting for 49.3%, followed by HP2-1 (38.0%), HP1-1 (7.2%). In addition, about 5.5% of individuals had HP del -related subtypes. The concentrations of the major subtypes (HP1-1, HP2-1, HP2-2) were significantly different, and it was necessary to establish reference ranges by grouping according to the results of the Z-test. The reference intervals were as follows: HP1-1, 0.37–2.19 g/L; HP2-1, 0.38–2.12 g/L; HP2-2, 0.12–1.51 g/L. Significant differences in HP concentrations between genders and ages were found, however, it was not necessary to establish separate reference interval since the results of the Z-test was negative. We have established reference ranges of serum haptoglobin concentrations based on subtypes, which are necessary for the clinical application of haptoglobin.

Nucleic acid based molecular technologies are the most promising tools for the early diagnosis of Candida infection. A simple and effective DNA preparation method is of critical for standardizing and applying molecular diagnostics in clinic laboratories. The goal of this study was to develop a Candida DNA preparation method that was quick to do, easy to perform, and bio-safe. Snailase and lyticase were screened and combined in this work to enhance the lysis of Candida cells. The lysis solution composition and metal bath were optimized to boost amplification efficiency and biosafety. A duplex real-time PCR was established to evaluate the sensitivity and specificity of the preparation method. Using the supernatant from the rapid preparation method as templates, the duplex PCR sensitivities for five common Candida species were determined to be as low as 10 0 CFUs. When compared to conventional preparation methods, the samples prepared by our method showed higher PCR detection sensitivity. PCR identification and ITS sequencing were 100% consistent, which was better than biochemical identification. This study demonstrates a rapid method for Candida DNA preparation that has the potential to be used in clinical laboratories. Meanwhile, the practical application of the method for clinical samples needs to be proven in future investigations.

Invasive candidiasis (IC) is often a cause of severe concern for the hospitalized patients, particularly those who are critically sick. However management of this disease is challenging due to a lack of effective laboratory diagnostic techniques. Hence, we have developed a one-step double antibody sandwich enzyme-linked immunosorbent assay (DAS-ELISA) using a pair of specific monoclonal antibodies (mAbs) for the quantitative detection of Candida albicans enolase1 (CaEno1), which is considered as an important diagnostic biomarker for IC. The diagnostic efficiency of the DAS-ELISA was evaluated by using a rabbit model of systemic candidiasis and compared with other assays. The method validation results demonstrated that the developed method was sensitive, reliable, and feasible. The findings of the rabbit model plasma analysis indicated that the diagnostic efficiency of the CaEno1 detection assay was better in comparison to the (1,3)-β-D-glucan detection and blood culture. CaEno1 is present in the blood of infected rabbits for a brief period and at relatively low levels and thus the combination of CaEno1 antigen and IgG antibodies detection could aid to increase diagnostic efficiency. However, to improve the clinical application of CaEno1 detection in the future, efforts should be made to increase the detection limit of the test by promoting technical developments and by optimizing the protocol for the clinical serial determinations.

念珠菌作为一类最常见的人类机会性致病菌,会导致重症和免疫功能低下患者的高发病率和死亡率.其自身有效的策略可入侵宿主并逃避宿主防御系统.而宿主对抗念珠菌的能力取决于天然免疫应答和适应性免疫应答.宿主体内大量免疫细胞和免疫分子相互协作针对侵入性的真菌做出反应.该文就宿主对念珠菌感染免疫应答机制作一综述.

Purpose The glycolytic enzyme enolase plays important role in the pathogenesis of Candida albicans infection and has been also considered as a promising molecular marker for the diagnosis of invasive candidiasis. This study aimed to investigate the location and secretion features of Candida albicans enolase (CaEno) with a couple of specific monoclonal antibodies (mAbs). Methods Two mAbs named 9H8 and 10H8 against CaEno were generated by fusing SP2/0 myeloma cell with the spleen lymphocytes from CaEno immunized mice. The specificity of the mAbs was then validated by Western blot and liquid chromatography-mass spectrometry (LC–MS/MS). A diverse set of experiments were conducted based on the pair of mAbs which involved immunohistochemical staining analysis, whole cell enzyme-linked immunosorbent assay (ELISA), double antibody sandwich ELISA, and confocal microscopy to analyze the possible location and secretion features of CaEno. Results CaEno is abundantly expressed in the cytoplasm of C. albicans blastospores and is distributed in a ring-shaped pattern along the cell wall. CaEno appeared in the hyphal C. albicans as just a “mushroom” form. CaEno was found to be weakly expressed on the surface of blastospores but constantly expressed at various stages of growth. CaEno concentrations in C. albicans blastospores culture supernatant are considerably higher than in C. albicans hyphae culture supernatant. The dynamic changes of supernatant CaEno concentration in blastospores and hyphal C. albicans exhibit distinct features, although both appear to be associated with the C. albicans growth state. When cultivated under normal circumstances, however, no apparent CaEno degradation was seen in the cell-free supernatant. Conclusion Our results implied that CaEno was constantly expressed on the cell surface and its secretion features varied according to the growth stage of C. albicans . However, further experimental and theoretical studies are needed in future to identify the specific mechanisms by which this phenomenon can arise.

OBJECTIVE:The multicenter literature review and case studies of 3 patients were undertaken to provide an updated understanding of nocardiosis, an opportunistic bacterial infection affecting immunosuppressed nephrotic syndrome (NS) patients receiving long-term glucocorticoid and immunosuppressant treatment. The results provided clinical and microbiological data to assist physicians in managing nocardiosis patients.METHODS:Three cases between 2017 and 2018 from a single center were reported. Additionally, a systematic review of multicenter cases described in the NCBI PubMed, Web of Science, and Embase in English between January 1, 2001 and May 10, 2021 was conducted.RESULTS:This study described three cases of Nocardia infection in NS patients. The systematic literature review identified 24 cases with sufficient individual patient data. A total of 27 cases extracted from the literature review showed that most patients were > 50 years of age and 70.4% were male. Furthermore, the glucocorticoid or corticosteroid mean dose was 30.9 ± 13.7 mg per day. The average time between hormone therapy and Nocardia infection was 8.5 ± 9.7 months. Pulmonary (85.2%) and skin (44.4%) infections were the most common manifestations in NS patients, with disseminated infections in 77.8% of patients. Nodule/masses and consolidations were the major radiological manifestations. Most patients showed elevated inflammatory biomarkers levels, including white blood cell counts, neutrophils percentage, and C-reactive protein. Twenty-five patients received trimethoprim-sulfamethoxazole monotherapy (18.5%) or trimethoprim-sulfamethoxazole-based multidrug therapy (74.1%), and the remaining two patients (7.4%) received biapenem monotherapy. All patients, except the two who were lost to follow-up, survived without relapse after antibiotic therapy.CONCLUSIONS:Nephrotic syndrome patients are at high risk of Nocardia infection even if receiving low-dose glucocorticoid during the maintenance therapy. The most common manifestations of nocardiosis in NS patients include abnormal lungs revealing nodules and consolidations, skin and subcutaneous abscesses. The NS patients have a high rate of disseminated and cutaneous infections but a low mortality rate. Accurate and prompt microbiological diagnosis is critical for early treatment, besides the combination of appropriate antibiotic therapy and surgical drainage when needed for an improved prognosis.

目的 探讨红细胞分布宽度（RDW），血小板平均体积（MPV）和中性粒细胞淋巴细胞比值（NLR）对系统性红斑狼疮（SLE）的诊断价值。方法 回顾性分析66例SLE患者与75名健康体检者的相关临床数据，依据SLEDAL-2000准则评判SLE患者的疾病活动情况将患者分为活动组和缓解组。比较活动组、缓解组、健康组的白细胞（WBC）、血小板（PLT）、中性粒细胞（N）、淋巴细胞（L）、血红蛋白（HBG）、RDW、MPV、NLR、红细胞沉降率（ESR）、C反应蛋白（CRP）、补体（C）的差异。Spearman相关性分析SLE患者RDW、MPV、NLR与其他指标的相关性，用ROC曲线比较各指标的诊断性能。结果 SLE组患者N、RDW和NLR均显著高于正常对照组，PLT、L和HGB显著低于正常对照组。与缓解期组相比，活动期SLE患者RDW和CRP显著升高；与对照组相比，SLE活动期组和缓解期组患者RDW和NLR显著升高，而MPV在各组间无明显差异。相关性分析显示，RDW与SLEDAI评分呈正相关，NLR与CRP呈正相关，MPV与C4呈负相关。ROC曲线分析显示RDW是评估SLE活动度有价值的指标，AUC为0.79，当cutoff值为47.5时，敏感度为78.95%，特异性为70.21%。结论 RDW与NLR在SLE患者中均有明显变化，RDW是可用于评价SLE疾病活动度的有用指标。

Malaria is caused by protozoan parasitic Plasmodium infections. Plasmodium falciparum is common in Africa; P ovale, P malaria and P vivax infections are less prevalent and globally confined, contributing to major causes of global mortality and morbidity, particularly in children in sub-Saharan African countries. In 2018, the total incidence of malaria increased from 221 million to 229 million, with an estimated 503 000 deaths reported. Sub-Saharan Africa has the highest number of cases of malaria and highest mortality rate compared with other countries, like southeastern Asia, east Pacific, western, and America with an estimated 213 million cases. In addition, continuous exposure to Plasmodium parasites results in the production of partial immunity to guard against more problems, resulting in asymptomatic carriers. The diagnosis of asymptomatic malaria is not simple because of the apparent absence of clinical factors and sometimes low levels of parasites. The most basic concept appears to be parasitemia and a lack of malaria signs, primarily fever (axillary temperature <37.5° C). Thus, a better awareness of asymptomatic malaria epidemiology in affected countries will help improve strategies to reduce the local burden of malaria and its health consequences. Therefore, the objective of this study was to determine the magnitude of asymptomatic malaria pathology and related risk factors with epidemiologic characteristics in individuals on the African continent.

Background Since urine cultures are only guaranteed for patients with obvious urinary symptoms in most cases, most of candiduria episodes are ignored in clinic. Objective This study aimed to design a screening protocol to improve diagnostic efficiency of candiduria, and provide information of Candida species and drug susceptibility. Methods All patients, who were admitted to the intensive care unit (ICU) of our hospital during December 1, 2018 and October 1, 2019, were enrolled in this study. Urinalysis was performed every three days for each subject from the first day of ICU admission. Urine specimens were sampled for fungal culture with either condition: (1) yeast-like cell counting (YLCC) ≥200; (2) positive YLCCs were observed in two consecutive tests, and at least one YLCC ≥100. Results The screening protocol dramatically improved the candiduria diagnostic rate of ICU patients from 2.28% to 17.27%. However, compared to the historical control, the screening protocol has no time-saving advantage in candiduria diagnosing. Higher percentage of C. albicans in screening protocol-identified candiduria patients was observed, although there was no statistical difference. Our results indicated that female gender, pneumonia, diabetes and infarction/hemorrhage patients were more prone to develop candiduria. Non-candiduria patients showed a better tendency for survival and shorter ICU stay length. Multisite colonization was common in the surveyed candiduria patients, who were up to 70.83% showed Candida positive cultures in sputum. Conclusion The screening protocol established in the study was a convenient and practical tool for early warning and feasible management of candiduria and IC.

目的 探讨高强度电磁辐射对电子对抗官兵外周血淋巴细胞的影响.方法 选取2020年3—4月参加1个月电子对抗军事演习任务的某部官兵45例为观察组,选取同期无强电磁辐射暴露史的同驻地体检健康官兵44名为对照组.军事演习后第3、90天检测2组血常规、大颗粒淋巴细胞(LGL)及淋巴细胞亚群数值并分析其变化.结果 与军事演习结束后第3天比较,2组军事演习结束后第90天白细胞、淋巴细胞百分比及绝对值、LGL百分比及绝对值差异均无统计学意义(P>0.05).与对照组比较,军事演习结束后第3、90天,观察组LGL百分比和绝对值均高于对照组,差异具有统计学意义(P<0.01).与对照组比较,观察组军事演习结束后第3、90天总T细胞、CD8+T细胞增高,CD4+T细胞、CD4+/CD8+比值及B细胞值减低,差异有统计学意义(P<0.01).与军事演习结束后第3天比较,观察组军事演习结束后第90天,总T细胞和CD8+T细胞减低,B细胞和CD4+/CD8+比值增高,差异有统计学意义(P<0.01).结论 电磁辐射可能导致电子对抗部队官兵外周血LGL数量持续升高,临床应加强监测及时干预;同时该类官兵短期内免疫功能下降,脱离强电磁辐射后免疫功能可得到部分恢复.

自20世纪80年代初起,全世界真菌感染的发病率和流行率逐年上升,其主要致病菌是念珠菌.世界上许多国家报道了由各种念珠菌引起的侵袭性感染,尤其是血流感染,这是影响住院患者发病率和死亡率的重要因素.有研究证明其在人体内的异常定植和增殖是引起内源性感染的关键环节,尤其当机体抵抗力下降、真菌寄居部位改变或寄居的微生物菌群平衡失调时更易发生[1].因此,探索念珠菌感染与定植之间的关系有助于念珠菌感染的预防和控制.本文就念珠菌侵袭性感染与定植的关系进行综述.

Invasive candidiasis is a major challenge to clinical medicine today. However, traditional fungal diagnostic techniques and empirical treatments have shown great limitations. Although efforts are necessarily needed in methodology standardization and multicenter validation, polymerase chain reaction (PCR) is a very promising assay in detecting fungal pathogens. Using a "heat-shock" DNA preparation method, a rapid and simple PCR protocol for quantification of the Candida albicans (C. albicans) ribosomal DNA was established. The PCR assay could detect Candida DNA as low as 10 CFU/mL in samples prepared by the heatshock protocol, without any cross-reaction with DNA prepared from other Candida spp. and bacterial pathogens. For simulated blood samples, the PCR test sensitivity of whole blood samples was better than that of plasma and blood cells. In the systemic candidiasis murine model, detectable DNA was only observed within 24 h after C. albicans SC5314 injection, which is much shorter than that observed in the kidney.

Background Polarized M2 macrophages are an important type of tumor-associated macrophage (TAM), with roles in the growth, invasion, and migration of cancer cells in the tumor microenvironment. Dihydroartemisinin (DHA), a traditional Chinese medicine extract, has been shown to inhibit the progression and metastasis of head and neck squamous cell carcinoma (HNSCC); however, the effect of DHA on cancer prevention, and the associated mechanism, has not been investigated in the tumor microenvironment. Materials and Methods First, human Thp-1 monocytes were induced and differentiated into M2 macrophages using phorbol 12-myristate 13-acetate (PMA), interleukin-6 (IL-6), and interleukin-4 (IL-4). Induction success was confirmed by cell morphology evaluation, flow cytometry, and quantitative real-time polymerase chain reaction (qRT-PCR). Then, DHA was applied to interfere with M2 macrophage polarization, and conditioned medium (CM), including conditioned medium from M2 macrophages (M2-CM) and conditioned medium from M2 macrophages with DHA (M2-DHA-CM), was obtained. CM was applied to Fadu or Cal-27 cells, and its effects on cancer invasion, migration, and angiogenesis were evaluated using transwell, wound-healing, and tube formation assays, respectively. Finally, Western blotting was used to evaluate the relationship between signal transducer and activator of transcription 3 (STAT3) signaling pathway activation and M2 macrophage polarization. Results Human Thp-1 monocytes were successfully polarized into M2-like TAMs using PMA, IL-6, and IL-4. We found that M2-like TAMs promoted the invasion, migration, and angiogenesis of HNSCC cells; however, DHA significantly inhibited IL-4/IL-6-induced M2 macrophage polarization. Additionally, as DHA induced a decrease in the number of M2-like TAMs, M2-DHA-CM inhibited the induction of invasion, migration, and angiogenesis of Fadu and Cal-27 cells. Finally, DHA inhibited M2 macrophage polarization by blocking STAT3 pathway activation in macrophages. Conclusion DHA inhibits the invasion, migration, and angiogenesis of HNSCC by preventing M2 macrophage polarization via blocking STAT3 phosphorylation.

Candiduria are common findings in clinic especially in hospitalized patients, while its significance remains undetermined. Since there are few criteria to follow, physicians tended to make decisions by personal experience in many cases in clinical practice. The present study was designed to unveil the present situation of candiduria management in hospitalized patients in clinical practice. A total of 251 hospitalized candiduria patients were retrospectively enrolled in the study. Clinical data on patient demographics, basic conditions, catheter using, urinary symptoms, laboratory data, and antifungal therapies were obtained from electronic medical records. The high rate of the candiduria cases were managed inappropriately after the introduction of the Infectious Diseases Association of America (IDSA) evidence-based recommendations, both in the management of urinary catheter and antifungal agents. Overtreatment was common in asymptomatic candiduria patients. For symptomatic patients, improper drug selections were not rare. In addition, a part of candiduria patients did not receive antifungal therapies although the IDSA recommends. A statistically significant difference was only found in hospital charges of symptomatic candiduria patients managed following IDSA or not. The recurrence rate, mortality, and hospital stay length were similar in candiduria patients regardless of the clinical management. Physicians tend to start empiric antifungal therapy for candiduria patients with pneumonia, multisite of Candida colonization, higher urine Candida CFUs, and long hospital stay. Candiduria has not received special attention today, and empirical antifungal treatment is common. IDSA guidelines are important to standardize the management of candiduria in clinic; however, the significance of the guidelines needs to be further clarified in future multicenter investigations.