SYSTEMATIC REVIEW article
Front. Cell. Infect. Microbiol.
Sec. Clinical Infectious Diseases
Volume 15 - 2025 | doi: 10.3389/fcimb.2025.1674143
The Impact of Long-Term Urinary Catheterization on the Risk of Fungal Urinary Tract Infections
Provisionally accepted
- Zhongjiang County People's Hospital, Deyang, China
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Background Fungal urinary tract infections (FUTIs), often caused by Candida species, are increasingly recognized in patients with long-term catheterization. However, the relationship between catheter dwell time and fungal infection risk remains unclear. This study aimed to quantify the risk of FUTIs associated with different durations of catheter use. Methods We conducted a systematic review and meta-analysis of cohort studies published between 2010 and 2024. Electronic databases including PubMed, Embase, and Web of Science were searched. The primary outcome was the incidence of FUTIs stratified by catheterization duration (≤7 days, >7 days, >14 days, >28 days). Risk ratios (RRs) and 95% confidence intervals (CIs) were pooled using a random-effects model. Subgroup and sensitivity analyses were performed. The quality of evidence was assessed using the GRADE approach. Results A total of 47 cohort studies involving over 56,000 participants were included. Compared with short-term catheterization (≤7 days), long-term catheterization (>7 days) significantly increased the risk of FUTIs (RR = 3.82, 95% CI: 3.27–4.46). The risk rose rapidly during the early period of catheterization (RR = 2.60 for >7–14 days) and then plateaued with continued catheter use (RR = 3.17 for >14–28 days, RR = 4.17 for >28 days). Subgroup analyses confirmed the robustness of the findings across clinical settings and patient populations. The overall certainty of evidence was rated as moderate. Conclusions Prolonged catheterization increases the risk of FUTIs, with the risk rising rapidly during the initial period and then remaining elevated during continued catheterization. Catheter dwell time exceeding 7 days may serve as a critical threshold for infection prevention interventions. These findings support revising current catheter management protocols and developing early-warning systems for fungal infection risk.
Keywords: Fungal urinary tract infection, Catheter-associated infection, long-term catheterization, Candida, Meta-analysis, Infection Control
Received: 27 Jul 2025; Accepted: 09 Oct 2025.
Copyright: © 2025 Zhang, Zhou, Shi, Jiang and Fang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Min Zhou, med_zhongjiang2025@163.com
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