European Journal of Molecular & Clinical Medicine

Abstract

Background: Candida causes urinary tract infections in persons with conditions such as
diabetes, prolonged hospitalization, instrumentation, prior antibiotic therapy etc. Mere
presence of Candida in urine is not indicative of true infection and it requires other evidence
such as pyuria, symptoms suggestive of urinary tract infection, repeated isolation of same
organism etc.
Objective: The study was done to estimate prevalence of Candiduria in the hospital and to
know the predominant species causing the same. The study also determined antifungal
susceptibility pattern of the isolates
Materials and methods: Routine urine samples suspected of urinary tract infection sent to
laboratory for culture and antibiotic sensitivity testing were analyzed. Culture on routine
media were done, followed by speciation using Auxanography method of sugar assimilation.
Antifungal susceptibility testing was done following CLSI guidelines using fluconazole and
voriconazole discs.
Results: Prevalence of Candiduria was estimated to be around 2.2% amongst urine samples.
C. tropicalis was the predominant species (51%), followed by C. albicans (26%). Other
Candida species isolated were C. glabrata (11%), C. guelliermondi (6%), C. parapsilosis
(4%) & C. krusei (2%). All isolates were susceptible to voriconazole. Two isolates of C.
tropicalis was intermediately sensitive to Fluconazole, whereas one isolate of C. krusei was
resistant to fluconazole.
Conclusion: The prevalence rate of 2.2% of Candiduria was similar to few studies observed.
Pyuria was noted in 80% isolates highlighting the non-reliance of pyuria in cases of
Candiduria. Majority of the isolates had colony count of >104cfu/ml, which is significant in
diagnosis of urinary tract infection. Non-albicans Candida (NAC) were the predominant
group (74%), which is in consonant with global trend of increasing prevalence of NAC
species in Candida infection. Certain species are developing resistance to routinely used
antifungals like Fluconazole, notably C. krusei. It was also noted in the study. The study
highlights the importance of knowledge of various Candida species causing Candiduria and
their antifungal resistance pattern.