Antifungal susceptibility of Candida species isolated from candidura

Candiduria is one of the most common symptoms of urinary tract infections caused by several species of Candida spp.. Several antifungals are available to treat such candidal infections. During the last decades, resistance to antifungal especially to non-albicans species has increased. Objectives: The present study aimed to evaluate the susceptibility to antifungal drugs of Candida species isolated from candiduria in Ahvaz. Materials and Methods: Ninety three species of yeasts and yeast like organisms isolated from urine samples [Candida albicans (58), C. glabrata (25), C. tropicalis (4), C. krusei (1), unknown Candida species (4) and Geotrichum species (1)] were used for susceptibility tests. All species were re-identified based on standard mycological methods. Then a suspension of each isolate of overnight cultures was prepared in 1ml of sterile PBS and adjusted to 0.5 McFarland turbidity standards. In the present study several antifungal drugs (fluconazole, amphotericine B, ketoconazole, econazole, itraconazole) were used for susceptibility test using disk diffusion method. Results: In the present study all tested isolates were sensitive/dose dependent to amphotericine B and nystatin, whereas only one isolate of C. glabrata was resistant to both antifungals. Resistance against fluconazole (48.4%) and ketoconazole (26.9%) were observed among tested isolates. Resistance against fluconazole was detected among all tested organisms, 34.4% of C. albicans, and 7.5% of C. glabrata. On the other hand, all isolates were sensitive to econazole (93.5% sensitive, 6.5% dose dependent). Conclusions: It was concluded that Candida species isolated from candiduria in hospitalized patients had excellent in vitro sensitivity against econazole. Other suitable antifungal drugs were amphotericine B and nystatin, itraconazole. Whereas, resistance against ketoconazole (26.9%) and especially fluconazole (48.4%) was significant.