Prevalence of albicans and non-albicans candiduria in a Malaysian medical centre

Objective: To determine the proportion of albicans and non-albicans candiduria in a hospital setting and to ascertain if fluconazole is still suitable as empirical antifungal therapy based on antifungal susceptibility patterns of Candida species. Methods: The cross-sectional study was conducted between December 2010 and December 2011 at UKM Medical Centre, Kuala Lumpur, Malaysia and comprised 64 urine samples from patients who were either suspected or confirmed to have urinary tract infections. Yeasts were speciated using ID 32 C and subjected to antifungal susceptibility testing using Sensititre® YeastOne YO8. Results: Candida albicans accounted for 38(59.4%) of the isolates, Candida tropicalis 18(28.1%), Candida glabrata 6(9.4%) and Candida parapsilosis 2(3.1%). Overall, the isolates were susceptible to both amphotericin B (MIC90 1μg/ml) and to 5-flucytosine (MIC90 0.25 μg/ml), but susceptible-dose dependent towards fluconazole (MIC90 16μg/ml). Individually, Candida albicans was susceptible to fluconazole (MIC90 2μg/ml), amphotericin B (MIC90 0.5μg/ml) and 5-flucytosine (MIC90 0.25μg/ml). Candida tropicalis was also susceptible to fluconazole (MIC90 4μg/ml), amphotericin B (MIC90 1μg/ml) and 5-flucytosine (MIC90 0.125μg/ml). Candida glabrata was resistant to fluconazole (MIC90 64μg/ml), but susceptible to amphotericin B (MIC90 1μg/ml) and 5-flucytosine (MIC90 0.125μg/ml). Lastly, Candida parapsilosis was resistant to fluconazole (MIC90 256μg/ml), but susceptible to amphotericin B (MIC90 0.5μg/ml) and 5-flucytosine (MIC90 0.5μg/ml). Conclusion: The commonest yeast associated with candiduria at the study site was Candida albicans, and fluconazole can still be used for empirical therapy of candiduria.