What is the appropriate treatment for a patient with a fungal urinary tract infection due to Nakaseomyces, with a urine culture showing 30-50,000 Colony-Forming Units per milliliter (CFU/mL)?

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Management of Nakaseomyces Urinary Tract Infection

For Nakaseomyces (formerly Candida glabrata) with 30-50,000 CFU/mL in urine, treatment depends critically on whether the patient is symptomatic and has risk factors—if asymptomatic, remove the urinary catheter if present and observe without treatment; if symptomatic or high-risk, treat with fluconazole 200 mg daily for 2 weeks after confirming fluconazole susceptibility. 1

Initial Assessment: Colonization vs. True Infection

The colony count of 30-50,000 CFU/mL falls below the traditional threshold of 50,000 CFU/mL used to distinguish true UTI from contamination in catheterized specimens, though this threshold is being reconsidered when coupled with symptoms and pyuria. 1

Key clinical decision points:

  • Asymptomatic candiduria almost always represents colonization, not infection, and does not require antifungal therapy in most patients. 1
  • Treatment is indicated only if: the patient has urinary symptoms (dysuria, frequency, urgency, suprapubic pain, or flank pain with fever), is a very low birth weight neonate, is neutropenic with fever, or is undergoing urologic instrumentation. 1, 2, 3
  • Candiduria does not commonly lead to candidemia, and treatment does not reduce mortality in asymptomatic patients—it serves as a marker of underlying illness severity rather than a cause of death. 1

Non-Pharmacologic Management First

Remove or replace indwelling urinary catheters if present—this alone resolves candiduria in approximately 40-50% of asymptomatic patients without any antifungal therapy. 2, 3, 4, 5

Additional predisposing factors to address include discontinuing unnecessary antibiotics and optimizing diabetes control. 6, 7

Species-Specific Considerations for Nakaseomyces

Nakaseomyces (formerly Candida glabrata) has critical differences from other Candida species:

  • Nakaseomyces is frequently fluconazole-resistant or has reduced susceptibility compared to C. albicans. 1
  • Obtain species identification and antifungal susceptibility testing before initiating therapy, as treatment selection depends entirely on fluconazole susceptibility. 8, 6

Treatment Algorithm Based on Susceptibility

If Fluconazole-Susceptible:

Oral fluconazole 200 mg (3 mg/kg) daily for 2 weeks is the treatment of choice for symptomatic cystitis. 1, 2, 9

  • Fluconazole achieves high urinary concentrations with the oral formulation and is the preferred agent due to safety and efficacy. 4, 5, 10
  • For pyelonephritis or upper tract infection, increase to fluconazole 200-400 mg (3-6 mg/kg) daily for 2 weeks. 2

If Fluconazole-Resistant:

For fluconazole-resistant Nakaseomyces, use amphotericin B deoxycholate 0.3-0.6 mg/kg daily for 1-7 days OR oral flucytosine 25 mg/kg four times daily for 7-10 days. 1, 3

  • Amphotericin B deoxycholate is preferred for resistant organisms as it achieves adequate urinary concentrations. 6, 4
  • Flucytosine can be used alone or in combination with amphotericin B for synergy, though resistance can develop when used as monotherapy. 3, 8, 5

Critical Pitfalls to Avoid

Do not use echinocandins (caspofungin, micafungin, anidulafungin) for urinary tract infections—they achieve inadequate urinary concentrations and have documented treatment failures. 3, 4, 5

Do not treat asymptomatic candiduria in most patients, as treatment does not improve outcomes and candiduria typically represents colonization. 1

Do not assume fluconazole will be effective for Nakaseomyces without susceptibility testing—this species has high rates of fluconazole resistance. 1, 6

Special High-Risk Populations Requiring Treatment

Even if asymptomatic, treat candiduria in:

  • Very low birth weight neonates (use amphotericin B deoxycholate 1 mg/kg daily or fluconazole 12 mg/kg daily if not on fluconazole prophylaxis). 2
  • Neutropenic patients with fever, though recent evidence suggests this may not always be necessary. 1
  • Patients undergoing urologic instrumentation (treat periprocedure to prevent candidemia). 1, 3

Monitoring and Follow-Up

Obtain follow-up urine cultures to document clearance after completing therapy. 3, 8

If treatment fails despite appropriate therapy, obtain imaging (ultrasound or CT) to identify fungus balls, hydronephrosis, abscesses, or structural abnormalities. 2, 3, 8

Fungus balls require surgical intervention in addition to antifungal therapy for cure. 2

Duration of Therapy

Continue treatment for 2 weeks for uncomplicated symptomatic cystitis, or until symptoms resolve and urine cultures no longer yield Nakaseomyces. 2, 3, 8

For upper tract infections or complicated cases, more prolonged therapy (2-4 weeks) may be necessary. 8

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Treatment of Candida tropicalis UTI

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Treatment of Candida Urinary Tract Infection with Urinary Retention

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

Research

Candida urinary tract infections: treatment options.

Expert review of anti-infective therapy, 2007

Research

Candida urinary tract infections--treatment.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2011

Research

[Management of fungal urinary tract infections].

Presse medicale (Paris, France : 1983), 2007

Research

Fungal urinary tract infections in patients at risk.

International journal of antimicrobial agents, 1999

Guideline

Treatment of Non-Candida Yeast Urinary Tract Infections

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Fluconazole dose recommendation in urinary tract infection.

The Annals of pharmacotherapy, 2001

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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