Study of candida species colonizing urinary tract in catheterized patients from intensive care units

Background: The overwhelming majority of fungal infections of the urinary tract are caused by Candida species, and they usually present as complicated nosocomial infections. Colonization of the bladder most commonly is a complication of prolonged catheterization of bladder in a patient receiving antibiotics Objectives to assess the significance of candiduria in catheterized patients admitted in ICUs, to study the significance of speciation of candida isolates and determine the predominant Candida species. Methodology: A total of 17 yeast isolates obtained from sixty catheterised urine samples collected from ICU patients after consent were included in the present study for final analysis. The candida isolates were identified upto species level by standard mycological techniques like wet mount, and culture on SDA. For speciation, rapid method – CHROM agar, cornmeal agar and germ tube test were used. Results: The mean age of the patients was 46.9 ± 19.7 (mean ± SD). Of the 17 patients from whom the Candida spp. were isolated 9 (52.9%) were female and 8 (47.1%) were male. The mean duration of ICU stay and catheterisation were 3.8 ± 2.2 and 3.76 ± 2.3, respectively. Of the 17 patients, 7 (41.2%) had diabetes mellitus. Of the 17 yeast isolates, Nonalbicans Candida spp. (76.47%) was the predominant colonizer (Table 3). In our study group, Candida tropicalis and Candida glabrata accounted for 29.4% each, followed by C. krusei 11.7% and C. parapsilosis (5.88%), whereas C. albicans accounted for 23.57 % of the cases. Conclusions: The Nonalbicans Candida species are more difficult to treat and chances that these strains would remain persistent are higher thus species identification should also be performed for appropriate management of ICU patients. The use of chromogenic media is an easy and reliable method for presumptive identification of commonly isolated Candida species. Speciation will help in selection of antifungal agents as C. glabrata and C. krusei are inherently resistant to azoles.