This in large part explains the increase in CNS bacteremia. However, the number of positive blood cultures out of the total cultures obtained may be helpful. There are certain issues regarding the acquisition of blood cultures that can decrease the percent of blood cultures that are contaminants. Blood culture teams consistently do better than house staff. Candida in the urine frequently represents colonization particularly in association with indwelling urinary catheters.
True infection is uncommon compared with colonization.
They recommend first verifying the presence of the organism by repeating a urine microscopy and culture. Of course, the urine should be carefully collected with a clean-voided midstream urine sample. If candida is absent with the second urine collection it means that the first positive sample represented either contamination or self-limited candiduria. The physician should then consider the patient and risk factors as outlined above and stratify them into one of three categories. The first category includes previously healthy individuals with asymptomatic candiduria.