Determination of Predisposing Factors in Developing Candida albicans Associated Urinary Tract Infection and Antifungal Sensitivity Profile

Abstract

Aim: Candiduria is very common in hospitalized patients. It poses a clinical challenge for the physicians since it is usually asymptomatic. The aim of this study was to identify risk factors associated with nosocomial candiduria in urinary tract infection (UTI) suspected patients in Methodology: Intensive Care Unit (ICU) and to determine their antifungal sensitivity profile. The urine specimens (168) were collected, microscopically screened for presence of yeast, cultured and analyzed for counting, isolation, phenotypic identification of Candida albicans. and testing antifungal resistance profile. Data regarding age, gender, use of catheter, use of antibiotics, diabetes mellitus among patients was also recorded. Results: Out of 168 specimens, C. albicans were isolated from 69 specimens, whereas 20 specimens showed other Candida spp. Age >45 years, gender female, previous use of antibiotics, urinary catheterization, stay in ICU >1 week were found the main predisposing factors (p<0.05) responsible for developing nosocomial candiduria. All C. albicans isolates were found either susceptible or susceptible-dose dependent to fluconazole, amphotericin B and voriconazole; however, 62.32% of the isolates were resistant to itraconazole. Conclusion: Most frequent candiduria, possible predisposing factors in ICU patients and resistance of C. albicans towards itraconazole is alarming and highlights the need of candiduria surveillance.