English

Abstract

BACKGROUND AND OBJECTIVES: Fungal urinary tract infections have become frequent, as a result of increased use of broad spectrum antibiotics, corticosteroids, immunosuppressive drugs and bladder catheters in acute care settings. The associated risk factors which are seen in cases of candiduria are: antibiotic therapy, female gender, urinary catheterization, surgical procedure and extended hospitalization. Candiduria has become a potential source of morbidity and mortality if untreated. We undertook a prospective study to note the incidence of non-Candida albicans in patients with urinary tract infection with special reference to speciation, antifungal susceptibility and the associated risk factors. METHODS: Candida species isolated from urine samples of patients with urinary tract infection were subjected to speciation using standard yeast identification protocol and CHROM agar. Antifungal Susceptibility testing was done by the disc diffusion method to amphotericin B and fluconazole. Clinical details and risk factors of the patients were noted down. RESULTS: Among the 60 culture positive cases, six Candida species which were isolated are : C.tropicalis (66.66%), C.albicans (13.33%), C.parapsilosis (8.33%), C.glabrata (6.66%), C.kefyr (3.33%) and C.guilliermondii (1.66%) The susceptibility pattern showed, that of the 60 isolates, 40% were resistant to fluconazole. No resistance was seen to amphotericin B. CONCLUSION: Isolation of non-Candida albicans species was more than Candida albicans. Candida tropicalis was the predominant isolate. The following risk factors were noted: 43.33 % of the patients had diabetes mellitus, 30%had history of prolonged antibiotics (cephalosporin and aminoglycosides), 16.66% had underlying renal pathology, 3.33% had post -renal transplant status, 1.66% were on steroids, 1.66%had pregnancy and 3.33% had no identifiable risk factors.20% patients had an indwelling catheter in them. The antifungal resistance was more in the non-Candida albicans species than in Candida albicans. Hence there is a need for speciation, susceptibility testing of Candida species.