Distribution of yeasts in fungal urinary tract infections from a tertiary care hospital

Abstract

Aims: Urinary tract infections caused by fungi in critically ill patients steadily increasing in recent years. Fungiuria is a marker of contamination, colonization, or infection in the lower or upper urinary tract. As urinary catheters especially long-term usage was the most important risk factor for fungiuria. The identification of yeast isolates at the species level is crucial for the appropriate management of infection. We conducted this study to describe the epidemiological features of fungiuria in patients. Methods: The yeast species were identified by using conventional methods and automated systems. Demographic data were recorded from the electronic medical records. Results: Candida albicans, were predominant compared to non-albicans Candida species and yeast-like fungi. Among non-albicans Candida, the most common species were Candida tropicalis followed by Candida glabrata complex. Fungiuria was more common in females than in males. Underlying conditions were present in patients the most common risk factors were antibiotic therapy before the detection of yeasts and using a urinary catheter. Conclusion: Epidemiological data and antimicrobial therapy play an important role in the treatment of urinary tract infections. For this reason, the identification of fungi at the species level is critical to assist the decision on antifungal therapy in complex cases. In all patients with fungal growth in urine culture, the underlying risk factors should be evaluated first. Depending on the correction of risk factors, fungiuria may resolve spontaneously. This is seen as the best approach both to reduce treatment costs and to prevent resistance to antifungals.