Home⇛The PCMC Journal⇛vol. 15 no. 2 (2019)

Utility of Urine KOH in Detecting Candidura in Infants

Mark Joseph S. Castellano | Mary Antonette C. Madrid

 

Abstract:

BACKGROUND: Candida species are common cause of urinary tract infection in infants requiring medical care. Candida fungal elements may be demonstrated in urine using microscopic examination with 10-20% KOH. However, detection of these elements does not always correlate with candiduria. OBJECTIVES: The main objective of this study was to establish the utility of urine KOH in identifying candiduria in terms of sensitivity, specificity, PPV, and NPV. The study also aims to determine the risk factors, as well as urinalysis and CBC parameters associated with candiduria. METHODS: This prospective study included admitted infants 1 year and below with urine culture request and with any risk factor for candiduria. Additional urine KOH testing was done using clean catch or catheter method (for those with indwelling catheter). RESULTS: Among the 90 study participants, 13 had candiduria (14%). The use of indwelling catheter, presence of urinary tract anomalies, leukocyte esterase in urinalysis, and increased monocyte counts in CBC are all associated with development of candiduria. Urine KOH had a sensitivity of (100%; CI 75.2- 100%), specificity (59.7%; CI 47.9-70.7%), PPV (29.5%; CI 17.7-45.2%), and NPV (100%; CI 92.2- 100%) in detecting candiduria. CONCLUSIONS: A negative urine KOH has excellent negative predictive value, while a positive result does not always mean true infection. RECOMMENDATIONS: This study recommends that urine KOH results be interpreted with caution depending on patient‘s risk factors clinical status and other laboratory tests such as urine culture and that a positive urine KOH result will not always require prompt treatment.



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