A case of pyelonephritis and bacteremia caused by Candida glabrata in a patient on sodium glucose cotransporter 2 inhibitor, successfully treated with micafungin
Abstract Background Background factors for Candida spp. detection in urine include indwelling urinary catheters, diabetes mellitus, and a history of antimicrobial exposure; nevertheless, urinary tract infections caused by Candida spp. are usually rare. Fluconazole (FLCZ) is a preferable drug for the...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-08-01
|
| Series: | Journal of Pharmaceutical Health Care and Sciences |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40780-025-00475-w |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849234809717522432 |
|---|---|
| author | Shoko Sahara Teruhisa Kinoshita Norio Takimoto Keisuke Oka |
| author_facet | Shoko Sahara Teruhisa Kinoshita Norio Takimoto Keisuke Oka |
| author_sort | Shoko Sahara |
| collection | DOAJ |
| description | Abstract Background Background factors for Candida spp. detection in urine include indwelling urinary catheters, diabetes mellitus, and a history of antimicrobial exposure; nevertheless, urinary tract infections caused by Candida spp. are usually rare. Fluconazole (FLCZ) is a preferable drug for the treatment of urinary tract infections caused by Candida spp.; however, some cases of urinary tract candidiasis resistant to FLCZ have been observed, making the selection of a therapeutic agent difficult. Recently, an increase in fungal genital infections has been reported alongside the increase in the use of sodium glucose cotransporter 2 (SGLT2) inhibitors. Although these medications have not been shown to increase urinary tract infections, concerns persist that they may promote colonization of the genital tract by Candida spp. and cause retrograde urinary tract infections, particularly in women. This is a rare case of Candida glabrata induced pyelonephritis and bacteremia in a patient receiving SGLT2 inhibitors, successfully treated with micafungin (MCFG). Case presentation A patient in her 70s under active treatment for breast cancer was diagnosed with a urinary tract infection and bacteremia caused by C. glabrata. The patient was taking SGLT2 inhibitors, and had no history of urinary catheter placement or antimicrobial exposure. In order to avoid the side effects of amphotericin B (AmB) and flucytosine (5-FC), the patient was treated with MCFG and FLCZ for 17 days. No adverse events or recurrence were recorded over the subsequent three months. Conclusions Patients taking SGLT2 inhibitors may be more susceptible to urinary tract infections caused by Candida glabrata, and in cases of azole-resistant Candida spp. urinary tract infection, MCFG may be a treatment option when AmB or 5-FC is difficult to use. |
| format | Article |
| id | doaj-art-e638d9e9da77441e859e0a37213fe5e8 |
| institution | Kabale University |
| issn | 2055-0294 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Pharmaceutical Health Care and Sciences |
| spelling | doaj-art-e638d9e9da77441e859e0a37213fe5e82025-08-20T04:03:01ZengBMCJournal of Pharmaceutical Health Care and Sciences2055-02942025-08-011111710.1186/s40780-025-00475-wA case of pyelonephritis and bacteremia caused by Candida glabrata in a patient on sodium glucose cotransporter 2 inhibitor, successfully treated with micafunginShoko Sahara0Teruhisa Kinoshita1Norio Takimoto2Keisuke Oka3Department of Pharmacy, Kariya Toyota General HospitalDepartment of Pharmacy, Kariya Toyota General HospitalDepartment of Pharmacy, Kariya Toyota General HospitalDepartment of Infectious Diseases, Nagoya University HospitalAbstract Background Background factors for Candida spp. detection in urine include indwelling urinary catheters, diabetes mellitus, and a history of antimicrobial exposure; nevertheless, urinary tract infections caused by Candida spp. are usually rare. Fluconazole (FLCZ) is a preferable drug for the treatment of urinary tract infections caused by Candida spp.; however, some cases of urinary tract candidiasis resistant to FLCZ have been observed, making the selection of a therapeutic agent difficult. Recently, an increase in fungal genital infections has been reported alongside the increase in the use of sodium glucose cotransporter 2 (SGLT2) inhibitors. Although these medications have not been shown to increase urinary tract infections, concerns persist that they may promote colonization of the genital tract by Candida spp. and cause retrograde urinary tract infections, particularly in women. This is a rare case of Candida glabrata induced pyelonephritis and bacteremia in a patient receiving SGLT2 inhibitors, successfully treated with micafungin (MCFG). Case presentation A patient in her 70s under active treatment for breast cancer was diagnosed with a urinary tract infection and bacteremia caused by C. glabrata. The patient was taking SGLT2 inhibitors, and had no history of urinary catheter placement or antimicrobial exposure. In order to avoid the side effects of amphotericin B (AmB) and flucytosine (5-FC), the patient was treated with MCFG and FLCZ for 17 days. No adverse events or recurrence were recorded over the subsequent three months. Conclusions Patients taking SGLT2 inhibitors may be more susceptible to urinary tract infections caused by Candida glabrata, and in cases of azole-resistant Candida spp. urinary tract infection, MCFG may be a treatment option when AmB or 5-FC is difficult to use.https://doi.org/10.1186/s40780-025-00475-wCandida glabrataSodium glucose cotransporter 2 inhibitorMicafunginUrinary tract infection |
| spellingShingle | Shoko Sahara Teruhisa Kinoshita Norio Takimoto Keisuke Oka A case of pyelonephritis and bacteremia caused by Candida glabrata in a patient on sodium glucose cotransporter 2 inhibitor, successfully treated with micafungin Journal of Pharmaceutical Health Care and Sciences Candida glabrata Sodium glucose cotransporter 2 inhibitor Micafungin Urinary tract infection |
| title | A case of pyelonephritis and bacteremia caused by Candida glabrata in a patient on sodium glucose cotransporter 2 inhibitor, successfully treated with micafungin |
| title_full | A case of pyelonephritis and bacteremia caused by Candida glabrata in a patient on sodium glucose cotransporter 2 inhibitor, successfully treated with micafungin |
| title_fullStr | A case of pyelonephritis and bacteremia caused by Candida glabrata in a patient on sodium glucose cotransporter 2 inhibitor, successfully treated with micafungin |
| title_full_unstemmed | A case of pyelonephritis and bacteremia caused by Candida glabrata in a patient on sodium glucose cotransporter 2 inhibitor, successfully treated with micafungin |
| title_short | A case of pyelonephritis and bacteremia caused by Candida glabrata in a patient on sodium glucose cotransporter 2 inhibitor, successfully treated with micafungin |
| title_sort | case of pyelonephritis and bacteremia caused by candida glabrata in a patient on sodium glucose cotransporter 2 inhibitor successfully treated with micafungin |
| topic | Candida glabrata Sodium glucose cotransporter 2 inhibitor Micafungin Urinary tract infection |
| url | https://doi.org/10.1186/s40780-025-00475-w |
| work_keys_str_mv | AT shokosahara acaseofpyelonephritisandbacteremiacausedbycandidaglabratainapatientonsodiumglucosecotransporter2inhibitorsuccessfullytreatedwithmicafungin AT teruhisakinoshita acaseofpyelonephritisandbacteremiacausedbycandidaglabratainapatientonsodiumglucosecotransporter2inhibitorsuccessfullytreatedwithmicafungin AT noriotakimoto acaseofpyelonephritisandbacteremiacausedbycandidaglabratainapatientonsodiumglucosecotransporter2inhibitorsuccessfullytreatedwithmicafungin AT keisukeoka acaseofpyelonephritisandbacteremiacausedbycandidaglabratainapatientonsodiumglucosecotransporter2inhibitorsuccessfullytreatedwithmicafungin AT shokosahara caseofpyelonephritisandbacteremiacausedbycandidaglabratainapatientonsodiumglucosecotransporter2inhibitorsuccessfullytreatedwithmicafungin AT teruhisakinoshita caseofpyelonephritisandbacteremiacausedbycandidaglabratainapatientonsodiumglucosecotransporter2inhibitorsuccessfullytreatedwithmicafungin AT noriotakimoto caseofpyelonephritisandbacteremiacausedbycandidaglabratainapatientonsodiumglucosecotransporter2inhibitorsuccessfullytreatedwithmicafungin AT keisukeoka caseofpyelonephritisandbacteremiacausedbycandidaglabratainapatientonsodiumglucosecotransporter2inhibitorsuccessfullytreatedwithmicafungin |