Candiduria in adults and children: prevalence and antifungal susceptibility in outpatient of Jataí-GO

Abstract

Introduction: The term candiduria refers to the presence of yeast in urine and Candida albicans is the most common agent. In general, routine laboratories do not perform identification and cultivation of yeast. Objectives: To determine the prevalence of Candida species and to evaluate the antifungal susceptibility of the species isolated in urine of outpatients Jataí-GO, between January-October 2013. Material and method: Urine samples containing fungal structures were plated out on Sabouraud agar with chloramphenicol. Differentiation was taken with the urease test, nitrogen and carbon sources assimilation, germ tube test, morphology on cornmeal agar and chromogenic agar cultivation. Susceptibility was evaluated at antifungal itraconazole, fluconazole, amphotericin B and ketoconazole. Results: 1,215 urine tests were performed, and 64 had fungal structures (5.3%). Two samples were lost, thus here we considered 62 isolates. From this total, 43 were identified as C. albicans (67.2 %), eight C. glabrata (12.5 %), five C. krusei (7.8%), three C. tropicalis (4.7%), and three could not determine the species (4.7%). Amphotericin B and ketoconazole inhibited 94.9% of the isolates. On the other hand, 55.9% and 54.2 % were resistant to itraconazole and fluconazole, respectively. The resistance rates of both fluconazole and itraconazole for C. glabrata and C. albicans, as fluconazole for C. albicans and C. krusei, showed significant differences (p < 0.05). Conclusion: These data demonstrate the importance of conducting a full identification and susceptibility to antifungal agents in samples with yeast infection.

Antifungal Resistance of Candida Species in Bacolod City, Philippines

“…Majority of the isolates were identified as C. albicans with a frequency of 61%. This is because C. albicans is the most common and most pathogenic [20] among Candida species [21] worldwide [22]. The findings of this study are similar to the study of Menezes [23], Bhattacharjee [9], and Lima [3].…”

“…Even so, there are several risk factors that contribute to candiduria which include instrumentation, prior surgical procedure, recent use of antibiotics, advanced age, sex (female), diabetes mellitus, immunosuppressed therapy, and prolonged hospital stay [35]. Moreover, the presence of Candida species in urine could possibly imply contamination [20] unless supported by pyuria after ruling out coexistent bacteriuria, or mechanical injury to the genitourinary tract [35].…”

Identification and antifungal susceptibility of Candida species isolated from the urine of patients in a university hospital in Brazil

“…The prevalence of C. parapsilosis , which was 4.7% in our study, in the other studies ranged from zero to 17.4% 16 , 31 - 37 . The evaluation of studies carried out in different regions of the country revealed a great similarity in the prevalence of Candida species among studies performed in the Midwest region 16 , 31 , 32 and those from the Southeast among themselves 34 , 35 , 37 . C. albicans is the most frequently found species in the digestive tracts of healthy people, and it has greater pathogenic mechanisms when compared to other Candida spp.…”

“…In Brazil, five studies from different regions evaluated the susceptibility to FLC of Candida species isolated from urine 5 , 32 - 34 , 45 . Using the broth microdilution method to evaluate C. albicans isolates, one study showed no resistance to FLC 34 , as did ours, and another showed 15.0% of resistance 5 .…”

Frequency of Candida Species Isolated from Patients in Children’s Medical Center, Tehran, Iran

“…However, in many studies C. albicans is still the most common cause of UTIs in children. De Sousa reported a higher prevalence (45%) of C. albicans in urine samples of outpatients (28).…”