Clinical microbiology and hospital infection control: candiduria: practice question

A Microbiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Microbiology · Clinical microbiology and hospital infection control: candiduria

Sample item

An afebrile, non-neutropenic ICU patient with an indwelling urinary catheter has Candida albicans at 100,000 CFU/mL in urine. No urologic procedure is planned. What is the best management?

AIntravenous amphotericin BBRemove or replace the catheter without antifungal therapyCOral fluconazole for 14 daysDBladder irrigation with amphotericin for 3 days

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Remove or replace the catheter without antifungal therapy

Asymptomatic candiduria usually represents colonisation of the catheter and bladder, and it usually clears with catheter removal. Antifungal therapy is reserved for symptomatic patients, neutropenia, low birth weight infants and before urologic procedures.

Option by option

A. Intravenous amphotericin B
Intravenous amphotericin is unwarranted in a patient without symptoms or risk factors.
B. Remove or replace the catheter without antifungal therapy (correct)
Correct. Remove the catheter and observe, because this is colonisation.
C. Oral fluconazole for 14 days
Treating colonisation with fluconazole is unnecessary and fosters resistance.
D. Bladder irrigation with amphotericin for 3 days
Bladder irrigation does not treat colonisation and is not recommended.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Microbiology question

What is the answer to this Microbiology question?

The best answer is B, Remove or replace the catheter without antifungal therapy. Asymptomatic candiduria usually represents colonisation of the catheter and bladder, and it usually clears with catheter removal.

Why is "Intravenous amphotericin B" not the answer?

Intravenous amphotericin is unwarranted in a patient without symptoms or risk factors.

Why is "Oral fluconazole for 14 days" not the answer?

Treating colonisation with fluconazole is unnecessary and fosters resistance.

Why is "Bladder irrigation with amphotericin for 3 days" not the answer?

Bladder irrigation does not treat colonisation and is not recommended.

What concept does this question test?

It tests Clinical microbiology and hospital infection control: candiduria in Microbiology. Antifungal therapy is reserved for symptomatic patients, neutropenia, low birth weight infants and before urologic procedures.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Clinical microbiology and hospital infection control: candiduria?

Make a one-line identity card for each organism: shape and stain, defining test, toxin, disease and drug. Then use the flashcards and the other Microbiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.