UROPATHOGENIC CANDIDA SPECIES AND THEIR SENSITIVITY TO ANTIFUNGAL AGENTS

doi:10.21608/aunj.2019.221118

UROPATHOGENIC CANDIDA SPECIES AND THEIR SENSITIVITY TO ANTIFUNGAL AGENTS

Document Type : Novel Research Articles

10.21608/aunj.2019.221118

Abstract

The present study included 400 patients admitted to Department of Urology, Assiut University Hospitals during the period from September 2015 to June 2016. The patients' ages ranged from 20- 84 years. The mycological analysis of their urine samples revealed that samples of 75 patients produced Candida colonies after culturing on Sabouraud`s dextrose agar and the rate of candiduria was highest in patients above 60 years of age (46.7%). Females were more affected than males (65.3% versus 34.7% of positive samples). Phenotypic (growth on Hicrome agar, microscopic examination,germ tube test, chlamydospore formation) and genotypic (sequencing ITS region of rDNA) allowed identification of four Candida species. Candida albicans was the most common species (41% of strains), followed by C. glabrata (34%), C. tropicalis (19%) and C. krusei (6%). Varying degrees of proteolytic and lipolytic activities was expressed by 65.12% and 90% of candida strains respectively. All strains of C. albicans, C. krusei and C. tropicalis were sensitive to Amphitericin-B and Nystatin. However these strains (except C. krusei) were resistant to each of Clotrimazole, Fluconazole and itraconazole Ketoconazole, Voriconazole where the percentage of resistant strains ranged from 47% to 100%. The majority of C. glabrata strains exhibited higher sensitivity to nystatin and fluconazole than to other tested antifungals. The higher incidence of non albicans candida (59% of strains) and resistance to the commonly used drug fluconazole is a matter of concern. It is recommended to perform routine mycological analysis for species identification of Candida isolates along with their antifungal susceptibility pattern to help the clinicians in better treating patients with candiduria.