Candiduria; a review article with specific data from Iran

Gharaghani, Maral; Taghipour, Simin; Halvaeezadeh, Marzieh; Mahmoudabadi, Ali Zarei

doi:10.5152/tud.2018.54069

Cited by 28 publications

(28 citation statements)

References 46 publications

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“…According to the findings of other studies in Iran, Candida albicans is the most common isolated species from candiduric patients (50–70%). However, recently, due to the increasing resistance to antifungal medications, non- albicans Candida species, including, C. glabrata (almost 20%), C. krusei , C. parapsilosis , and C. tropicalis have also been implicated [ 45 - 47 ].…”

Section: Discussionmentioning

confidence: 99%

High prevalence of asymptomatic nosocomial candiduria due to Candida glabrata among hospitalized patients with heart failure: a matter of some concern?

Âghili¹,

Abastabar²,

Soleimani³

et al. 2021

CMM

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Background and Purpose: Heart failure is a leading cause of hospitalization, and asymptomatic candiduria is common in hospitalized patients with low morbidity. However, in most patients, it is resolved spontaneously on the removal of the catheter. Despite the publication of guidelines, there are still controversies over the diagnosis and management of candiduria. However, in hospitalized patients with heart failure, the decision to treat candiduria is especially important since the nosocomial infections are associated with an increase in morbidity, mortality, length of hospital stay, and healthcare costs. Some species of Candida, such as Candida glabrata, are increasingly resistant to the first-line and second-line antifungal medications. The present study aimed to investigate the incidence of asymptomatic Candida urinary tract infection due to C. glabrata and antifungal susceptibility of Candida isolates in hospitalized patients with heart failure. Materials and Methods: In total, 305 hospitalized patients with heart failure were studied to identify asymptomatic nosocomial candiduria during 2016-17 in one private hospital in the north of Iran. The Sabouraud’s dextrose agar culture plates with a colony count of >104 colony-forming unit/ml of urine sample were considered as Candida urinary tract infection. Candida species were identified based on the morphology of CHROMagar Candida (manufactured by CHROMagar, France) and PCR-RFLP method with MspI restriction enzyme. Antifungal susceptibility testing of the isolates was performed using five mediations, including itraconazole, voriconazole, fluconazole, amphotericin B, and caspofungin by broth microdilution method according to CLSI M27-S4. Results: In this study, the rate of asymptomatic Candida urinary tract infection was 18.8%, which was more common in people above 51 years old and females (70%). In addition to the urinary and intravascular catheter, the occurrence of candiduria in hospitalized patients had significant relationships with a history of surgical intervention, diastolic heart failure, and use of systemic antibiotics (P>0.05). Among Candida spp., non-albicans Candida species was the most common infectious agent (59.7%). Moreover, C. glabrata (n=27, 40.3%) (alone or with other species) and Candida albicans (n=27, 40.3%) were the most common agents isolated in Candida urinary tract infection. Based on the results of the in vitro susceptibility test, the C. glabrata isolates were 15%, 59%, 70%, 74%, and 85% susceptible to caspofungin, amphotericin B, itraconazole, voriconazole, and fluconazole, respectively. Conclusion: According to the findings, there was a high prevalence of asymptomatic Candida urinary tract infection in hospitalized patients with heart failure. Besides, it was suggested that there was a shift towards non-albicans Candida, especially C. glabrata, in these patients. Therefore, asymptomatic candiduria in hospitalized patients with heart failure should be considered significant. Furthermore, the identification of Candida species along with antifungal susceptibility is essential and helps the clinicians to select the appropriate antifungal agent for better management of such cases.

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Section: Discussionmentioning

confidence: 99%

High prevalence of asymptomatic nosocomial candiduria due to Candida glabrata among hospitalized patients with heart failure: a matter of some concern?

Âghili¹,

Abastabar²,

Soleimani³

et al. 2021

CMM

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“…For example, Harris et al be-lieved that C. glabrata was well adapted to substrate availability, osmolality, and urine pH (6). Hence, the C. glabrata species complex has been introduced as the second agent of candiduria (7). According to the SENTRY Surveillance Program (2008 to 2009), C. glabrata was 13.7, 5.2, 15.7, and 23.5% prevalent in the Asia Pacific, Latin America, Europe, and North America, respectively (8).…”

Section: Introductionmentioning

confidence: 99%

Genetic Analysis of Candida glabrata from Candiduric Patients Using Microsatellite Length Polymorphism, Antifungal Susceptibility, and Enzymatic Profiles

Gharaghani

Rezaei‐Matehkolaei

Hardani

et al. 2021

Jundishapur J Microbiol

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Background: Candida glabrata is the second agent of candiduria with increased resistance to antifungals. Microsatellite length polymorphism (MLP) is one of the genotyping techniques used in the epidemiological investigation to improve clinical management. Objectives: We aimed to detect different genotypes of C. glabrata isolates using six microsatellite markers and the MLP technique. Moreover, our genotypes' association with other countries' genotypes was illustrated using a minimum spanning tree. We investigated in vitro antifungal susceptibility and enzymatic activity profiles of the isolates. Methods: Six microsatellite markers were amplified using multiplex-PCR for 22 C. glabrata strains isolated from urine in pediatric patients admitted to the Abuzar Children's Hospital in Ahvaz, Iran. The PCR products were presented for fragment analysis, and the size of the alleles was determined. Antifungal susceptibility tests and extracellular enzyme activities were also performed. Results: Nineteen multilocus genotypes were detected so that 22.7% of the strains had identical genotypes. The isolates were wild-type for amphotericin B (0.0625 - 2 µg/mL), itraconazole (0.125 - 2 µg/mL), and voriconazole (0.0078 - 0.00625 µg/mL). All the isolates were sensitive to fluconazole at the MIC range (0.0312 - 16 μg/mL), and three of them were resistant to caspofungin (MIC ≥ 0.5 μg/mL). Moreover, 72.7 and 68.2% of the isolates had no phospholipase and esterase activities. The highest potency of enzymatic activity was obtained in hemolysin and proteinase enzymes. A high genetic diversity (19 genotypes of the 22 isolates) existed among the urinary C. glabrata isolates. Based on the minimum spanning tree, two clusters of our genotypes were related to C. glabrata genotypes in a previous study in Iran, and the third cluster was entirely connected with Chinese genotypes. Conclusions: Most of the isolates were the non-wild type for posaconazole but were rarely resistant to other antifungals. Hemolysin and proteinase secreted as the main virulence factors among the urinary C. glabrata isolates.

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“…Catheter associated urinary tract infection (CAUTI) represent one of the highest rates of occurrence among hospitalized patients, comprising about 36% of HAIs (Aly et al, 2016). Hence, urinary tract instrumentation and prolonged hospital stay are predisposing factors for developing nosocomial UTIs (Gharaghani et al, 2018 Journal homepage: http://www.ijcmas.com Hospital acquired infections (HAIs) are the commonest untoward incident in healthcare delivery worldwide that not only bring additional medical cost but also, extend hospital stay and affect patient's morbidity and mortality. Urinary tract infections (UTIs) account for majority of these infections.…”

Section: Introductionmentioning

confidence: 99%

Microbial Spectrum and Antibiotics Susceptibility Profile of Nosocomial Urinary Tract Infections in Mansoura Oncology Center

Gomaa¹,

Mashad²,

Deeb³

et al. 2020

Int.J.Curr.Microbiol.App.Sci

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Candiduria; a review article with specific data from Iran

Cited by 28 publications

References 46 publications

High prevalence of asymptomatic nosocomial candiduria due to Candida glabrata among hospitalized patients with heart failure: a matter of some concern?

High prevalence of asymptomatic nosocomial candiduria due to Candida glabrata among hospitalized patients with heart failure: a matter of some concern?

Genetic Analysis of Candida glabrata from Candiduric Patients Using Microsatellite Length Polymorphism, Antifungal Susceptibility, and Enzymatic Profiles

Microbial Spectrum and Antibiotics Susceptibility Profile of Nosocomial Urinary Tract Infections in Mansoura Oncology Center

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