Candiduria: A diagnostic and therapeutic challenge

Introduction: Inrecent years, Candida sp. has appeared as an emerging nosocomial pathogen causing Urinary Tract Infections. Candiduria is difficult to diagnose clinically as most often the patient is asymptomatic. Patients with candiduria often develop candidemia. Standard urine culture is less sensitive. Resistance to antifungal drugs have been more commonly encountered in Candida species isolated from urine. Aim: Hence, the present study was undertaken to detect the incidence of different Candida species isolated from urine and to study their antifungal drug susceptibility profile. Material and Methods: 630 urine samples were cultured on Sabouraud’s Dextrose agar (SDA) with chloramphenicol. 55 Candida strains were detected by conventional tests. 05 Candida albicans and 07 Candida nonalbicans strains were further confirmed by Vitek2. Antifungal drug susceptibility profile was detected by disc diffusion method as per CLSI Guidelines. Minimum Inhibitory Concentration (MIC) of Fluconazole and Voriconazole was detected by E Test (bio Merieux). Results: Candida tropicalis was the commonest species (36.4%) followed by Candida albicans (29.1%), Candida parapsilosis (16.4%), Candida glabrata (7.3%) and Candida pelliculosa (7.3%). 22 (40%) Candida species were resistant to Fluconazole. Fluconazole MIC > 96 μg/ml was observed in 10 strains. Conclusion: Routinely all uine sample should be cultured on SDA for detection of Candiduria and antifungal drug sensitivity test should be done.