Epidemiology of urinary candidiasis and antifungal susceptibility pattern of various Candida species at a rural tertiary health care centre of Puducherry, South India- An observational study

Abstract

Urinary tract infection (UTI) is a common health problem across the globe. Although majority of them are bacterial in origin, there has been an increasing trend in the incidence of UTI due to the yeast like fungi, . UTI due to are in large proportion noscomially acquired and of growing concern is the development of resistance to the commonly used azole group of drugs for their treatment. Since the resistance is more commonly reported among non- albicans , routine species identification and antifungal susceptibility testing is crucial for successful clinical outcomes. This study was conducted to analyse the distribution and risk factors associated with Urinary candidiasis and also to determine the resistance patterns of different to various antifungal agents using phenotypic methods. : A hospital based observational study was conducted from September 2016 to December 2017 on patients presenting with symptomatic UTI. isolates were speciated using phenotypic methods like germ tube test and growth character on chromagar . Antifungal susceptibility to fluconazole, voriconazole, ketoconazole and amphotericin B were determined using disc diffusion method. All data were anlyzed using EpiData Analysis software version 2.2.2.186. A total of 101 were isolated. The incidence of Urinary candidiasis was more among females (66.4%) than in males (33.6%). People above 50 years (38.6%) were commonly affected followed by people in the age group of 21-30 years (22.7%). The incidence among hospitalized patients was 86.7% and urinary catheterization (43.5%) was the most commonly associated risk factor. The most common isolates were tropicalis (31.6%) followed by albicans (21.7%). The overall resistance patterns among various were 50.5%, 32.7%, 19.9% and 2% for fluconazole, ketoconazole, voriconazole and amphotericin B respectively. Hospitalization and urinary catheterization are the important risk factors for developing urinary candidiasis. The antifungal susceptibility varies among different and hence, identification of to species level along with antifungal susceptibility testing should be practiced as a routine in all clinical mycology laboratories.