Distribution and antifungal susceptibility profile of Candida species from candiduria cases at a tertiary care hospital

Abstract

The present study was conducted to assess the distribution of Candida species in candiduria and to evaluate their antifungal susceptibility pattern. Urine samples were subjected to microscopy and screened for the growth. Candida isolates were identified and speciated by colour on HiCHROM Candida agar, germ tube test, growth in cornmeal agar to study micromorphology, carbohydrate assimilation and fermentation tests according to standard protocols. All isolates were investigated for antifungal susceptibility testing. During the study period, a total number of 2560 urine samples were reported. Out of them 94/2560 (3.7%) urine samples showed significant candiduria. 60 from catheterised patients admitted to the ICU and 34 from patients admitted in different wards. The species-wise distribution among Candida isolates are C.tropicalis 53 (56.4%), C.albicans 21(22.4%), C.glabrata 8 (8.5%), C. krusei 7 (7.4%) and C.parapsilosis 5 (5.3%). Candida species exhibited resistance to Amphotericin B 6 (6.4%), Fluconazole 23 (24.5%) Voriconazole 8 (8.5%), Flucytosine 5 (5.3%) and 4 (4.3%) to Caspofungin. Candida previously presumed as non-pathogenic has attained an important clinical role in nowadays circumstances of growing risk factors and developing antifungal resistance. The frequency of isolation of non- albicans Candida was more when compared to Candida albicans and they showed more resistance to antifungal drugs when compared to C.albicans. Caution must be taken in reporting Candida from urine, but it is recommended not to mistreat candiduria. The Candida species identification along with their antifungal susceptibility profile can assist clinicians in choosing better antifungal drugs for the treatment of patients with candiduria.