Urinary Candida Research Articles

Molecular typing and fluconazole susceptibility of urinary Candida glabrata isolates from hospitalized patients

At our community teaching hospital between August 1994 and August 1995, Candida glabrata accounted for 14% of all Candida isolates and for 31% of urinary Candida isolates. The culture site was urine for 68% of C. glabrata isolates compared to 30% of all Candida isolates ( p < 0.001, χ 2). To study the association between C. glabrata and isolation from the urine, we analyzed all available C. glabrata urinary isolates over a 3-month period (23 isolates from 20 patients) using electrophoretic karyotyping, random amplified polymorphic DNA analysis, and fluconazole susceptibility testing. Random amplified polymorphic DNA generated eight types, although electrophoretic karyotyping generated 17 types. Combining the two methods resulted in 19 types indicating that urinary C. glabrata strains at our hospital are genetically diverse and the association between C. glabrata and urinary tract isolation does not appear to be due to horizontal transmission of a single or small number of strains. In vitro susceptibility tests showed that C. glabrata isolates from patients receiving fluconazole had significantly higher minimum inhibitory concentrations to fluconazole than those not receiving fluconazole ( p < 0.05). Despite a limited number of patients and isolates, our data suggest that selection of less susceptible organisms by the presence of antifungal agents may be an important contributor to increased urinary isolation of C. glabrata from patients in our hospital.

Standardization and demonstration of antibody-coated Candida in urine by direct immunofluorescence test.

Acetone, carbontetrachloride, ethyl alcohol, mixture of ethyl alcohol and acetone, and heat were assessed for fixative property for direct immunofluorescent (IF) staining of antibody-coated Candida cells. The results indicated that ethyl alcohol was the most suitable fixative for the test. Antisera containing 16 units of Candida albicans type A agglutinin were found essential to get optimal detectable fluorescence of antibody-coated yeast cells. IF test showed cross reactivity between the yeasts of C. albicans and C. tropicalis. However, there was no cross reactivity with the conidia of A. flavus. The direct IF test could demonstrate antibody-coated yeast cells and pseudomycelia in deposits of urine in the direct smear. It correlated well with microscopy and culture studies. At times, it could demonstrate the antibody-coated yeasts earlier than routine significant culture. It could also differentiate the significant from non-significant fungal isolates from urine.

Fungal infection in burn patients: Results of using 5-fluorocytosine (flucytosine)

Fungal infection and use of 5-fluorocytosine were studied prospectively among burn patients receiving multiple antibiotics. From 22 out of 23 patients positive cultures for Candida were obtained. Cultures from the mouth and rectum became positive first. Averaging 6 days later, 16 patients had positive urine cultures. Candida in urine was the best way to detect systemic candidiasis. Nine patients received 5-fluorocytosine. Although this drug did not influence survival among patients with burns of less than 59 per cent of body surface area, it prevented death from disseminated Candida infection among patients with burns of greater than 60 per cent body surface area. Patients with large surface burns receiving multiple antibiotics should have prophylaxis against fungi. If Candida is detected in urine, systemic treatment should be given. 5-Fluorocytosine is a safe and effective systemic drug for this purpose.

Flucytosine in urinary candida infections

Flucytosine (Ancobon), a chlorinated pyrimidine, was used in the treatment of 30patients with serious Candida infections of the urinary tract. Criteria for treatment included Candida counts greater than 10,000 colonies per milliliter; elevated serum antibody titers against Candida antigen, and lack of response to local antifungal therapy. Twenty-three of 30 patients (77 per cent): responded to treatment. Side effects were few and limited to reversible changes in liver function and bone marrow. Flucytosine given orally provides the physician with a new treatment for significant Candida infections.

Observations on 5-Fluorocytosine andCandida albicans

The numbers of colonies of Candida albicans which develop resistance to 5-fluorocytosine on 50% serum agar are significantly lower than those developed on 50% urine and Wickerham's agar media. Serum induces the hyphal growth form which is characterised by the presence of resting nuclei. There were fewer mitoses in the myeelial phase than in blastospore multiplication, and it is concluded that the rate of acquisition of resistance to 5-FC is related to this. The minimum fungistatie concentration of 5-FC for C. albicans is less in serum than in urine. In the treatment of urinary Candida infections, the emergence of isolates with total resistance to 5-FC in the urine is not necessarily a sign that the patient will fail to respond to therapy, since much of the fungistatic effect on the fungal colonisation in the tissue may still persist.

Study on the Candida in Patient with Pulmonay Tuberculosis The Third Report; Observation of Candida in Urine and Symptoms in Pulmonary Tuberculosis

Candida is studied in the urine of 150 cases of normal person and 168 cases of pulmonary tuberculosis. Positive rate of Candida species is 0.7%(♀, 1case) in normal person, 5.4% (♂, 7cases: ♀, 2cases) in pulmonary tuberculosis cases. There is a little relationship between the higher positive rate and pulmonary tuberculosis. The positive rate of Candida albicans is 100% in Candida positive normal person, 77.8% in Candida positive tuberculous patient(by the classification method following Martin's Method). The extend of tuberculous lesion, erythrocyte sedimentation rate, fever, cough, malaise, and weight loss are significantly related with the Candida positive rate. Age and sex of tuberculous patients, existence of vacity and mycobacterium tuberculosis, administration of antituberculosis drugs, amount of urine excreted, urine appearance, frequency of urination and painful urination seem to have no definite relationship with he Candida positive rate. Urine pH of Candida positive is found to be between 4.0 and 6.0. There does exist significant correlation ship between Candida positive rate in sputum and that in stool,m while there is no correlation ship between Candida positive rate in urine and that in sputum, as well as between the positive rate in urine and that in stool.