Urinary Candida isolates from a tertiary care hospital: Speciation and resistance patterns

Abstract

Background: Candida species (spp.) is an integral member of the human microbiota and is an opportunistic pathogen. This pathogen infects the urinary tract both by ascending the urinary tract and by haematogenous spread. Aim: Speciation and antifungal susceptibility patterns of Candida isolates from urine specimens. Materials and Methods: Yeast-like isolates from urine culture were identified using a Mini-API® (bioMerieux, Marcy-l'Etoile, France) tool with ID 32 C strips (bioMerieux, Marcy-l'Etoile, France) for species identification and ATB Fungus 3 strips (bioMerieux, Marcy-l'Etoile, France) for susceptibility testing to five antifungal agents and results interpreted as per Centers for Disease Control and Prevention (CDC) guidelines. The significance of data was analysed using the chi-square test. Results: Candida spp. isolation was 10.2% (112/1092) and the commonest was Candida tropicalis [54.5% (61/112)], followed by C. glabrata 25% (28/112), and C. albicans, 11.6% (13/112). C. albicans showed good susceptibility to Flucytosine (100%) and Amphotericin B (84.6%) while non-albicans Candida susceptibility was only 82.9% and 60.6%, respectively. Conclusion: Non-albicans Candida have replaced Candida albicans as the more common causative agent. Resistance to both Amphotericin B and Fluconazole is on the rise, requiring the judicial use of antifungals in the immunocompetent and immunocompromised host as therapeutic and prophylactic therapy.