Candida species in catheter associated urinary tract infection in ICU patients at a tertiary care hospital in North India: An observational study

Abstract

Introduction: Catheter associated urinary tract infection (CAUTI) is most common nosocomial infection which constitutes ~80% of nosocomial urinary tract infections (UTIs). Candida albicans has been most commonly isolated in past but in recent years non-albicans candida has emerged as the more common agent causing UTI in ICU settings. The study aimed to assess the burden of various candida species in symptomatic CAUTI in ICU patients and to test their susceptibility pattern for various antifungal agents. Materials and methods: Study was performed at a 1050 bed tertiary care hospital of northern India. Over a period of 1 year, total 147 urine samples from symptomatic CAUTI patients admitted in ICU were collected. Gram’s staining and culture on CLED agar was done. All yeast isolates were tested for speciation of Candida & antifungal susceptibility by an automated commercial system - VITEK 2. Results: Among 147 urine samples, 34 (23.12%) were positive for various Candida species. 61.76% positive patients were female and 38.23% were male. Maximum numbers of Candida isolates were found in above 60 years age group. 27 (79.41%) were due to non-albicans Candida spp. and 7 (20.58%) were due to Candida albicans. All Candida species were found to be sensitive to voriconazole, amphotericin B, caspofungin and micafungin. Few isolates of certain species like C.albicans and C.non-albicans showed resistance to fluconazole and/or flucytosine. Conclusion: Changing pattern of Candida species causing UTIs around the world points towards continuous need for surveillance, thus helping us in providing appropriate therapy.