Clinicomycological profile of candiduria in symptomatic patients in a tertiary care hospital in eastern india

Introduction: The detection of candiduria among hospitalised patients is not uncommon, but, candiduria in symptomatic patients are often significant. In ICU patients, candiduria is associated with increased mortality .Significant candiduria is presence of >=105 fungal CFU/ml of urine. Early detection and reporting of their susceptibility strongly determines the clinical outcome. Aims: To study the distribution of different Candida species in symptomatic candiduria patients, therisk factors, their susceptibility and patient’s outcome. Methods: Midstream, clean catch and catheterized urines in 100 symptomatic patients developing candiduria were tested in R.G.Kar Medical College and hospital for identification of isolates and their susceptibility patterns using conventional techniques. Outcome were observed. Results: In 100 symptomatic candiduria patients, predominantly females (66%) and age group 41-60 years (39%) were affected. Broad-spectrum antimicrobials usage(64%) and >5 catheter days (22 out of 30 catheterized patients) were most important risk factors associated. Most of patients were from in-patient wards(57%). Candida species isolated were Candida albicans (most common-48%), Candida tropicalis-45%, Candida glabrata-4%, Candida parapsilosis-2% and Candida guillermondii-1%. Sensitivities toVoriconazole-87%, Fluconazole-65%, Itraconazole-19% and Amphotericin B-37% of cases .30% patients subsequently developed candidemia. 90% of patients recovered, 3% died of urosepsis with MODS and rest died due to other causes. Conclusion: Candida albicans was mostly isolated and Voriconazole was
mostly sensitive. Candiduria in symptomatic patients can be an early indicator of an underlying sepsis and routine screening for candiduria should be done in all patients with high risk factors.