Assessment of virulence factors and antifungal susceptibility of Candida species isolated from catheter associated urinary tract infections

Background: The presence of Candida species in the urine is termed candiduria, and it is a common form of urinary tract infection (UTI). Many other species of Candida organism apart from Candida albicans are known with increasing the occurrence of resistance to available antifungal agents. Objectives: To determine the prevalence and sensitivity pattern of Candida isolates obtained from urine samples of diagnosed urinary tract infections. Methods: Midstream urine of patients attending the Lagos University Teaching Hospital, Ikeja Lagos, were collected and inoculated on Sabouraud Dextrose Agar (SDA). Microbiological processing was done with Gram reaction, germ tube test, CHROME agar TM and sugar fermentation test using API 32C system. Antifungal susceptibility tests were done using the agar disc diffusion method. Results: Candida species were obtained from 36 (12.9%) of 280 patients with UTI. Candida albicans (CA) had the highest frequency (12; 33.3%) compared to 24 (66.7%) for Non-albicans Candida (NAC). The speciation of Candida using Chrome Agar showed some misidentification from the API32C identification, but there was a significant correlation between API32C and Chrome Agar methods (r = 0. 9793). Half of the C. albicans species were sensitive to fluconazole while C. hellenica was only sensitive to Nystatin. The C. parapsilopsis had the highest susceptibility pattern, with 86% and 71% for fluconazole and ketoconazole, respectively. Generally, ketoconazole had the highest effectiveness on Candida species. Conclusion: This study demonstrated the role of Candida species in UTIs and their high susceptibility to ketoconazole.

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Urinary Isolates and Antifungal Susceptibility Pattern of Candida species Isolated from Patients in Tertiary Care

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i25a31451 ◽

2021 ◽

pp. 48-56

Author(s):

A. Arasi Samyuktha ◽

V. Illamani ◽

Chitralekha Saikumar

Keyword(s):

Urinary Tract ◽

Urinary Tract Infections ◽

Candida Species ◽

Culture Media ◽

Fungal Infections ◽

Antifungal Susceptibility ◽

Tertiary Care ◽

Hospitalized Patients ◽

Common Finding ◽

Tract Infections

Community-acquired urinary tract infections (UTIs) are fastidious growing infections caused by Candida fungal overgrowth that frequently occur in immunosuppressed hospital patients. Although many factors account for the increases in these fungal infections, the leading causes include the rise in medical device usage, immunosuppressant drugs, and interventional procedures. The emergence of drug resistant in Candidal species, which is largely attributed to use of prolonged and inappropriate empirical therapy, has further complicated patient management. The regularity of urinary tract infections (UTIs) due to Candida species is growing and these infections are most common clinical outcome, particularly in hospitalized patients. The microbiological invasions in any tissue of the urinary tract extend from the renal cortex to the urethral meatus. Candida UTI or candiduria is a common finding in hospitalized patients. To find out the ratio of Candida albicans to non- albicans Candida species to correlate the risk factors to the Candida species associated and to analyze the speciation of Candida isolates using the Chrom agar is a differential culture media, with sugar assimilation test. Constant surveillance of candiduria is important as C. tropicalis is more invasive, can lead to fatal candidemia. Identification of Candida up to species level is essential, as it can give an idea to the clinicians about appropriate antifungal therapy. Our study showed a predominance of non-albicans Candida spp. of about 86%. C. tropicalis (62%) was the most common isolate obtained followed by C. albicans (14%), C. glabrata (10%), C. krusei (9%) and C. parapsilosis (5%). Indwelling urinary catheter was an important associated risk factor for non-albicans candiduria.

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Epidemiology and antifungal susceptibility of Candida species isolated from urinary tract infections: A study from an intensive care unit of a tertiary care hospital

Indian Journal of Critical Care Medicine ◽

10.4103/ijccm.ijccm_130_17 ◽

2018 ◽

Vol 22 (1) ◽

pp. 56-57 ◽

Cited By ~ 5

Author(s):

Satinder Gombar ◽

Mandeep Kaur ◽

Jagdish Chander ◽

Priya Datta

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Candida Species ◽

Tertiary Care Hospital ◽

Antifungal Susceptibility ◽

Tertiary Care ◽

Care Hospital ◽

Tract Infections

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Urinary Tract Infections in Patients with Type 1 and Type 2 Diabetes: Etiology, Resistance to Antibacterial Chemicals and Virulence Features

Revista de Chimie ◽

10.37358/rc.17.3.5502 ◽

2017 ◽

Vol 68 (3) ◽

pp. 566-569 ◽

Cited By ~ 1

Author(s):

Mihaela Magdalena Mitache ◽

Carmen Curutiu ◽

Elena Rusu ◽

Ramona Bahna ◽

Mara Ditu ◽

...

Keyword(s):

Urinary Tract ◽

Virulence Factors ◽

Urinary Tract Infections ◽

Disk Diffusion ◽

Diffusion Method ◽

Diabetic Patients ◽

Disk Diffusion Test ◽

Tract Infections ◽

Susceptibility Profiles ◽

Diabetes Patients

One of the most frequent chronic complications occurred in diabetes patients are the urinary tract infections (UTIs). This study aimed to investigate the incidence of UTIs in a cohort of 93 (47 males: 46 females) diabetic patients, the prevalence of different microbial species involved and their virulence and antibiotic resistance profiles. The identification of the uropathogenic strains in the positive urine samples was performed using conventional methods and API tests. After identification, the antibiotic susceptibility profiles were established by the standardized disk diffusion method and double disk diffusion test was performed for the confirmation of ESBL and inducible AmpC b �lactamase phenotypes. The isolated strains were tested for the production of different cell associated and soluble virulence factors, i.e.: bacterial adherence to cellular substrata (HeLa cells), hemolysins (hemolysis spot, CAMP-like), amylase, caseinase, aesculin hydrolysis, DNA-ase, lipase and lecithinase. In the analyzed group, the total prevalence of UTIs was of 46%, a higher incidence being observed in the female patients (64%). Similar to other studies, the etiology of UTI in the investigated diabetes patients was dominated by E. coli, followed by Klebsiella sp. strains. The isolated strains preserved good susceptibility rates to quinolones and aminoglycosides and revealed important virulence features, related to their capacity to colonize the cellular substratum and to produce soluble virulence factors involved in persistence, colonization and progression of the infectious process. The high percentage of beta-lactam resistant strains (including carbapenem-resistant ones) requires careful surveillance of the dynamics of susceptibility profiles for limiting the emergence of these strains in community.

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