Detection and Antimicrobial Susceptibility of Candida Species Isolated from the Urine of Patients in a Tertiary Health Facility, Southwest Nigeria

Damola A. B.

Department of Medical Microbiology, School of Medical Laboratory Sciences, Lagos University Teaching Hospital Idi-Araba, Lagos, Nigeria.

Adeoshun O. V.

Department of Medical Microbiology, School of Medical Laboratory Sciences, Lagos University Teaching Hospital Idi-Araba, Lagos, Nigeria.

Bakarey A. S. *

Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria.

Udeh, U. N.

Department of Medical Microbiology, School of Medical Laboratory Sciences, Lagos University Teaching Hospital Idi-Araba, Lagos, Nigeria.

*Author to whom correspondence should be addressed.


Abstract

Aims: This study aimed to identify and determine the antimicrobial susceptibility profiles of Candida species causing UTI among patients attending a tertiary Teaching Hospital, in southwest Nigeria.

Study Design: Comparative cross-sectional study.

Place and Duration of Study: Lagos State University Teaching Hospital, Ikeja, Nigeria between June 2017 and February, 2018.

Methodology: A total of 250 participants whose provisional diagnosis was candiduria were recruited for this study. Urine samples were collected from consenting participants early in the morning into sterile wide mouth universal containers. These samples were cultured aerobically on Blood agar, Cystine-Lactose-Electrolyte Deficient (CLED) agar and Sabouraud dextrose agar (SAB) at 370C within 1 to 2 days. The isolates were profiled into species level using microscopic, biochemical test, chromogenic media (Chrom agar Candida) and Analytical Profile Index (API) 32C examination analysis.

Results: An overall rate for Candidiasis in this study was 12.8% (32/250). The rate was higher in female 17.5% compared to 6.5% in their male counterparts (p=0.014). Highest rate of infections peaked at 28.6% among age group 83-92 years and lowest (6.7%) in age group 23-32 years. A total of 11 (4.4%) urine culture from participants produced C. albicans pure fungi isolates. However, by gender, this was statistically significant (p=0.003). A total of 81 bacterial (32.4%) and fungal isolates 32 (12.8%) were isolated and profiled. Distribution of Candida species indicated highest incidence in age range 31-40 years, followed by 21-30years and age 61-70 years age brackets. The isolated species were Candida albicans 11(34.4%), C. tropicalis 8(25%), C. parapsilopsis 6(19%), C. krusei 2(6.3%) and C. hellenica 1(3.1%). Sixty to seventy percent of fungal isolates were susceptible to ketoconazole and fluconazole while the susceptibility pattern of Candida species to itraconazole, terbinafine and nystatin varied between moderately susceptible to resistance. All the Candida isolates were resistant to griseofulvin.  However, C. albicans was found to be the major Candida species causing Candidal urinary tract infection. The only C. hellenica isolated was resistant to all the antifungal drugs were approved except nystatin.

Conclusion: High profile of Candida isolates and related UTI microbes were found in this study. There is need for advocacy for the use of API and Chrom agar Candida for routine diagnosis for Candida identification. Nevertheless, the Candida isolates were mostly susceptible to ketoconazole and Fluconazole but only the isolates were griseofulvin resistant.

Keywords: Candida, antimicrobial susceptibility, sabouraud dextrose agar, antifungal disc, Nigeria


How to Cite

Damola A. B., Adeoshun O. V., Bakarey A. S., and Udeh, U. N. 2024. “Detection and Antimicrobial Susceptibility of Candida Species Isolated from the Urine of Patients in a Tertiary Health Facility, Southwest Nigeria”. International Journal of Pathogen Research 13 (3):90-104. https://doi.org/10.9734/ijpr/2024/v13i3289.

Downloads

Download data is not yet available.

References

Rubaihayo J, Tumwessigye NM, Konde-Lule J, Wamani H, Nakku-Joloba E, Makumbi F. Frequency and distribution patterns of opportunistic infections associated with HIV/AIDS in Uganda. BMC Res Notes. 2016;9:(1):501. Available:https://doi. org/10.1186/s13104-016-2317-7

Ferreira JA, Carr JH, Starling CE, de Resende MA, Donlan RM. Biofilm formation and effect of caspofungin on biofilm structure of Candida species bloodstream isolates. Antimicrob Agents Chemother. 2009;53:(10):4377-84.

Fisher J.F, Sobel J, Kaufman C.A and Newman C.A. Candida urinary tract infections – Epidermiology, Clinical Infection Disease. 2011;(52):6:433-436.

Salehi M, Ghasemian A, Shokouhi, Mosteafavi SK, Nojoomi F, Ashaiani D. The epidemiology of Candida species isolated from urinary tract infections. Arch Clin Infect Dis. 2016;11.

John FF, Kelvin K, Jack DS, Kauffmann CA. Journal of Clinical Infection Disease. Medical College, Georgia. 2011;52:6:5437-5451.

Achkar JM, Fries BC. Candida infections of the genitourinary tract. Clin Microbiol Rev. 2010;23(2):253-73.

Ellis, M. Invasive fungal infections: evolving challenges for diagnosis and therapeutics. Mol Immunol. 2002;38:947-957.

Ferreira JA, Carr JH, Starling CE, de Resende MA, Donlan RM. Biofilm formation and effect of caspofungin on biofilm structure of Candida species bloodstream isolates. Antimicrob Agents Chemother. 2009;53(10):4377-84.

Ali Zarei M and Majid Z. Antifungal susceptibility of Candida species isolated from Candiduria. Journal of microbiology. Department of medical mycology, School of Medicine, Iran; 2012.

Kauffman CA, Vazquez JA, Sobel JD, et al., “Prospective multicenter surveillance study of funguria in hospitalized patients. The National Institute for Allergy and Infectious Diseases (NIAID) Mycoses Study Group,” Clinical Infectious Diseases. 2000;30(1):14–18.

Loster JE, Wieczorek A, Loster BW. Correlation between age and Candida species infections of complete denture wearers: A retrospective analysis. Clin Interv Aging. 2016;2016(11):1707–1714. Available:https://doi.org/10.2147/CIA.S116658

Sanguinetti M, Posteraro B, Lass‐Flörl C. Antifungal drug resistance among Candida species: Mechanisms and clinical impact. Mycoses. 2015;58(Supp 2): 2–13. Available:https://doi.org/10.1111/myc.12330

Zadik Y, Burnstein S, Sandler V. Colonization of Candida; Prevalence among tongue- pierced and non tongue pierced immunocompromise adults. 2010; 16(2):172-5.

John FF, Kelvin K, Jack DS, Kauffmann CA. Journal of Clinical Infection Disease. Medical College, Georgia. 2011;52:6:5437-5451.

Lopes da Rosa J, Kaufman PD. Chromatin-Mediated Candida albicans Virulence; Biochem. Biophys Acta. 2013;1819:(3 -4):349 – 355.

Duke. Yeast infections in the urinary tract, increase risk of death in premature infants. Journal Clinical Research Institute 2012;40(4):1500–1503

Bougnoux M E. Candidemia and Candiduria in critical ill patients admitted to ICU in France. Incident,molecular diversity management and outcome. Intensive care Med. 2008;34:292-9.

Gharaghani M, Taghipour S, Halvaeezadeh M, Mahmoudabadi AZ. Candiduria; a review article with specific data from Iran. Turk J Urol 2018;44:445-452.

Richards M.J, Edward J.R, Culver D.H and Gaynes R.P. Nosocomial Infections in Combined Medical- Surgical Intensive Care Units in the United States. Journal of Infection Control Hosp Epidemiol. 2000;21(8):510-5.

Kauffman CA. Candiduria. Clinical Infectious Diseases. 2005;41: 371-376.

Paul N, Mathai E, Abraham O.C, Michael J.S, Mathai D. Factors associated with candiduria and related mortality. J Infect; 2007;55:450-5.

Harris AD, Castro J, Shepard D.C, Samore M.H. Risk factors for nosocomial candiduria due to Candida glabrata and Candida albicans. Clin Infect Dis 1999; 29:926-8.

Arslan S, Koç AN, Sekerci AE, et al. Genotypes and virulence fac+tors of Candida species isolated from oral cavities of patients with type 2 diabetes mellitus. Turk J Med Sci. 2016;46(1):18–27. Available:https://doi.org/10.3906/sag-1405-73

Dolinski K. and Botstein. Orthology and functional conservation in eucharyotes. Annu . Rev. Genet. 2007;41:465-507

Sehgal S.C. Epidemiology of male urethritis in Nigeria. J. Trop Med Hyg 1990;93:151-152.

Jawetz EJ, Melmic L, Adelberg EA. Medical microbiology. 22nd ed. Lange books, McGraw- Hill, London, 2001; 1017.

Ekpo IA, Kechia FA, and Iwewe YS, Ngueguim1 AD, Nangwat1 C and Dzoyemi JP. Species distribution and antifungal susceptibility profile of Candida spp isolated from the urine of hospitalised patients in Dschang District Hospital, Cameroon. Int J Biol Chem Sci 2017;11:1212-1221

Prescott J.P, Harley J.M, Klein D.A. Microbiology. 7th ed. Mc Graw Hill Publication, New York, USA 2008;

Paul N, Mathai E, Abraham O.C, Michael J.S, Mathai D. Factors associated with candiduria and related mortality. J Infect; 2007;55:450-5.

Lussier N, Laverdiere M, Delorme J, Weiss K, Dandavino R. Trichosporon beigelii funguria in renal transplant patients. Clin Infect Dis; 2000;31:1299-301.

Kao AS, Brandt ME, Pruitt WR. The epidemiology of Candidemia to United States Cities: results of a population- based active surveillance. Clin Infect Dis 1999;29:1164-1170.

Kiple and Kenneth F. The Cambridge World History of Human Disease. Cambridge University Press, Cambridge, New York, Victoria 1993.

Mayer FL, Wilson D, Hube B. Candida albicans, pathogenicity mechanisms,Virulence, 2013;9:119-128

Xu, J., Boyd, C. M., Livingston, E., Meyer, W. , Madden, J. F. and Mitchell, T. G. “Species and genotypic diversities and similarities of pathogenic yeasts colonizing women,” Journal of Clinical Microbiology, 1999;37:12:3835–3843

Abu-Elteen, K. H., “Increased incidence of vulvovaginal candidiasis caused by Candida glabrata in Jordan,” Japanese Journal of Infectious Diseases, 2001; 54:3:103–107

Lawal IA., Osinupebi OA., and Adeosun OV Prevalence and Antifungal Susceptibility Pattern of Candida species Isolated from Patients with Urinary Tract Infections Annals of Health Research 2021;7(4): 55-58.

Manzano GP, Hernandez H F, Zavala VN, Mendez-Tovar LJ, Naquid JM, Torres-Rodriguez JM. Candiduria in type 2 diabetes mellitus patients and its clinical significance. Rev Med Inst Mex Seguro Soc., 2008;46(6):603-10.

Mary EB, Kauffman CA, Peter GP, Naureem I, Maudi TS. Fungemia caused by Zygoascus hellenica in an Allogeneic stem cell transplant recipient. J. Clin Microbiol, 2004;42(7):3383-3385.

Lee BSB, Bhuta T, Simpson JM, Craig JC. Methanamine hippurate for preventing urinary tract infections (Review). The Cochrane collaboration, published by John Wiley & sons, ltd 2012;

Nelson MG, Richards BB, Steven LB, James WM. Manual of clinical problems in infectious disease. 5th edition, printed in USA 2006;126

Ochei J and Kolhathar A. Medical laboratory science, Theory and practical, Dept Microbiology, College of Medicine, Sultan Quboos University, Muscat, Tata McGraw –Hill Publishing Comp Ltd; 2000;1072-77.

Odds F.S. Candidiasis of the urinary tract. Candida and Candidosis: a review and bibliography. London; Balliaere Tindall. 1988;169-174.

Botstein D. and Fink G.R. Yeast: An experimental organism for 21st century biology. Genetics, 2011;189: 695-704.

Okungbowa F.O, Isuehuemhen O.S, Dede A. The distribution of frequency of Candida specie in the genitourinary tract among symptomatic individual in Nigeria cities. Rev Iberoam. Micol 2003;20:60-63.