THE SIGNIFICANCE OF FUNGURIA IN HOSPITALIZED PATIENTS

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。真菌尿路感染的发病率，主要是由念珠菌引起的，在住院患者中正在迅速增加。在短短十年内，重症监护病房中分离出的泌尿真菌比例从22%增加到39%。从泌尿道中分离的真菌的意义仍然是一个相当有争议的主题。我们将对真菌病住院患者进行为期12个月的前瞻性研究。对真菌感染患者进行纵向随访，观察感染的持续性和真菌感染的并发症。我们还将对未患真菌病的对照组患者进行类似规模的研究，以进行比较。这两个种群将用于创建一个大型数据集，从中可以开发模型，以回答真菌病是否与真菌血症、死亡率和与资源使用增加相关的发病率独立相关的问题。为了全面了解真菌感染的潜在并发症，我们计划随访真菌感染患者出院后长达1年的长期预后。我们将使用分子分型方法来调查真菌血症和真菌血症患者血液和尿液真菌分离株之间的菌株相关性。这种分子分型将确定从尿液中分离的真菌是否与严重的全身性感染有关，还是代表一种同步的、不相关的下呼吸道过程。从这些真菌病的综合研究中，我们将为真菌病的管理制定重点战略，旨在节省成本并减少由抗唑真菌引起的医院感染的发生率。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The incidence of fungal urinary tract infections, largely caused by Candida species, is rapidly increasing in hospitalized patients. In just a decade, the proportion of fungal urinary isolates from medical intensive care units has increased from 22% to 39%. The significance of fungi isolated from urinary tract remains a subject of considerable debate. We will perform a prospective study of hospitalized patients with funguria over a 12-month period. Patients with funguria will be followed longitudinally for persistence of infection and complications of funguria. We will also characterize similar-sized cohort of control patients known not to have funguria for comparison. These two populations will be used to create a large data set from which models can be developed to answer the questions of whether funguria is independently associated with fungemia, mortality, and morbidity associated with increased resource use. To comprehensively understand potential complications of funguria, we plan to follow long-term outcomes of patients with funguria up to 1 year after hospital discharge. We will use molecular-typing methods to investigate strain relatedness between blood and urine fungal isolates in patients who have both funguria and fungemia. This molecular typing will determine if fungi isolated from urine are associated with a serious systemic infection or represent a synchronous, unrelated lower tract process. From these comprehensive studies of funguria, we will develop focused strategies for the management of funguria that are intended to result in both cost savings and a reduction in the incidence of nosocomial infections caused by azole-resistant fungi.