Antifungal susceptibility of Candida species isolated from urine from patients in a neurosciences intensive care unit

Abstract

Background and Objectives: The incidence of fungal infections in immunocompromised patients, especially by Candida species, has increased in recent years. This study was designed to identify Candida species and determine antifungal susceptibility patterns isolated strains from urine samples of intensive care unit (ICU) patients. Materials and Methods: All the urine samples of neuroscience ICU patients were cultured on Blood agar, Cystine–Lactose–Electrolyte-deficient agar, and Sabouraud Dextrose Agar. The grown colony was identified with color pigmentation on Candida Differential Agar. The antifungal susceptibilities of all Candida species were carried out with fluconazole, amphotericin B, ketoconazole, itraconazole, clotrimazole, nystatin, and miconazole. The generated results were analyzed with SPSS software (Version 20, IBM Corp., Armonk, NY, USA). Results: Candida Species were found in both genders of ICU patients with respect to all age groups. Among 100 urinary tract infection patients, 14 individuals were affected with diabetes and cerebrovascular accident. Whereas other disease comorbidity renal tubular acidosis, subarachnoid hemorrhage, head injury, acute respiratory distress syndrome, hypertension, and others were 9, 8, 8, 5, 11, and 31, respectively. Candida albicans (38.09%) was the most frequently isolated species, followed by Candida glabrata (23.8%), Candida krusei (23.8%), and Candida tropicalis (2.85%). Resistance varies depending on the species and the respective antifungal agents. From among 7 antifungal agents, itraconazole showed highest percentage of sensitivity (81.8%). Conclusions: Species definition and determination of antifungal susceptibility patterns are advised for the proper management and treatment of patients at risk for systemic candidiasis. Resistance to antifungal agents is an alarming sign for the emerging common nosocomial fungal infections.