Species distribution and antifungal susceptibility profile of Candida isolated from urine samples

Abstract

Background: Candiduria is a common finding in hospitalized patients. The isolation of Candida from urine is challenging for both clinician and microbiologist as to whether the candiduria represents colonization or, lower or upper urinary tract infection including ascending pyelonephritis and renal candidiasis with sepsis. Although Candida albicans is the major cause of candiduria, non-albicans Candida (NAC) has emerged as an important opportunist pathogen. The NAC spp. are not only well adapted to the urinary tract but also are difficult to eradicate than C. albicans. Aims & Objective: The present study aimed to determine the clinico-mycological profile of candiduria in a tertiary care hospital. Material and Methods: A total of 218 Candida spp. isolated from urine samples were included in the study. Speciation of Candida was done by conventional methods and colony colour on HICHROM Candida agar. Antifungal susceptibility testing of the isolates was performed by disc diffusion method on glucose methylene Mueller-Hinton agar (GM-MH). Results: In both the sexes maximum patients belong to age group >50 years. Urinary catheterization, use of broad spectrum antibiotics and diabetes mellitus were the major risks. Isolation of NAC spp. was more. Maximum resistance was seen to fluconazole. Conclusion: The shift towards the NAC spp. as the causative agent of candiduria has generated the concern. Since several NAC spp. are inherently resistant to common antifungal agents, the rapid identification of Candida isolates upto species level along with its in-vitro antifungal susceptibility pattern is important for treatment and management of candiduria.

Five-year cross-sectional study to determine the burden ofCandidaspp. infections of the urinary tract system among patients attending tertiary hospital in Northwestern Tanzania

“…The increased episodes of NAC spp. causing infections like candiduria and candidaemia have been associated with increased prevalence of severe immunosuppression illness, prematurity, empirical use of antimycotic agents like fluconazole and overuse of broad-spectrum antibiotic 35–37. In the current study, NAC spp.…”

“…causing infections like candiduria and candidaemia have been associated with increased prevalence of severe immunosuppression illness, prematurity, empirical use of antimycotic agents like fluconazole and overuse of broad-spectrum antibiotic. [35][36][37] In the current study, NAC spp. were most prevalent among inpatients, while among outpatients, C. albicans were most prevalent.…”

“…Studies elsewhere have reported C. glabrata and C. tropicalis to be the leading NAC spp. causing candiduria 32 36. Due to the fact that Candida infections of the urinary tract are highly associated with disseminated candidiasis like candidaemia and deep-seated candidiasis,9 39 40 the management of patient with candiduria is advised to be in according to the susceptibility profile of the involved pathogen.…”