Background: There have been important changes in the epidemiology of Candida causing urinary tract infection (UTI) over the past decades. Candida species other than Candida albicans have now emerged as an important cause of UTI and some of which exhibit reduced susceptibility to commonly used antifungal agents. The aim of this study was to investigate species distribution and antifungal susceptibility profile of Candida species causing candiduria in Farwania hospital in Kuwait and asses its’ associated risk factors.
Materials and method: During a 12-month period, urine cultures were processed for isolation of Candida species. All the yeast isolates were sub-cultured on Sabouraud dextrose agar and processed for phenotypic identification by germ tube test and API ID 32C. Antifungal susceptibilities of the isolates were determined against amphotericin B, voriconazole, fluconazole and caspofungin by E-test. All the patients yielding Candida species in urine culture were assessed for risk factors.
Results: Of 13691 urine samples processed for culture, 2550 (18.6%) yielded microbial growth. Of these, 85 (3.3%) were identified as Candida UTI (CUTI) with an incidence of 3.3%. The ratio of female to male was 2:1. The average age of the patients was 54 yrs. The most common isolate was C. albicans (54%) followed by C. tropicalis (15%). The major predisposing factors were urinary tract catheterization (86.5%) and antibiotic therapy (68%).
Conclusion: The study reinforces the emerging importance of non-albicans Candida species in the epidemiology of candiduria. A better understanding of the associated risk factors and knowledge of susceptibility profile of the local Candida isolates may have therapeutic benefits.