Abstract :
Introduction: Fungal urinary tract infections (UTIs) are commonly caused by Candida species, with Candida albicans historically recognized as the most frequently isolated species. Differentiating between mere colonization and true infection—identifying whether the Candida is a uropathogen or a commensal—is essential for appropriate clinical management. Antifungal sensitivity testing is critical in guiding effective treatment, particularly in the face of increasing resistance.
Objective: The objective of this study was to analyze the microbial profile of candiduria, distinguish between uropathogenic and commensal Candida isolates, and evaluate their Antifungal sensitivity patterns at a tertiary care hospital in Vadodara, Gujarat.
Materials and Methods: This retrospective study was conducted over a one-year period, from January 1, 2022, to December 31, 2022. A total of 9,227 urine samples from patients suspected of having UTIs were analyzed. Isolation and identification of Candida species were performed using established microbiological methods, including culture on selective media and biochemical testing. Antifungal sensitivity testing was conducted following the Clinical and Laboratory Standards Institute (CLSI) guidelines using the broth microdilution method. Patient clinical data were reviewed to differentiate uropathogenic isolates from commensals based on factors such as colony counts, presence of symptoms, and associated risk factors.
Results: Out of the 9,227 urine samples analyzed, 2,751 (29.82%) exhibited significant microbial growth, with Candida species isolated in 67 (2.43%) of these cases. Of the 67 Candida isolates, 45 (67.16%) were identified as uropathogens, while 22 (32.84%) were categorized as commensals. Candida albicans was identified in 24 (35.82%) of the isolates, while non-albicans species accounted for 43 (64.18%), including C. tropicalis (25.37%), C. parapsilosis (20.90%), C. glabrata (11.94%), and C. krusei (5.97%). Antifungal sensitivity testing showed high sensitivity to echinocandins (caspofungin and micafungin), with varying
resistance patterns observed for azoles and amphotericin B among different species.
Conclusion: The study reveals a predominance of non-albicans Candida species in cases of candiduria and emphasizes the importance of accurate species identification and Antifungal sensitivity testing. Differentiating between uropathogenic and commensal isolates is vital for guiding appropriate treatment. Continuous monitoring is necessary to detect emerging resistance trends and to inform treatment strategies.
Keyword :
Candiduria, Candida albicans, Non-albicans Candida, Antifungal sensitivity, Uropathogen, Commensal