Prevalence of Candida species in Urinary Tract Infections from a Tertiary Care Hospital at Lucknow, Uttar Pradesh, India: A Retrospective Study

Introduction: The presence of Candida in urine, called Candiduria. Immunocompromised individuals are more susceptible to this infection and it can cause life-threatening complications. Candida albicans is most common isolate in Urinary Tract Infections (UTI) but in recent years this is shifting to non-albicans groups. Researchers found that azole is the drug of choice against Candida infections but due to excess use of these drugs resistance is developing more frequently for azole group drugs and drug resistant isolates are increasing gradually. A unique virulence factor i.e biofilm production, similarly like bacterial species is a crucial factor which contributes to the resistance against antifungal drugs. Aim: To assess the prevalence of Candida spp. in UTI retrospectively. Materials and Methods: The present retrospective study was conducted in Department of Microbiology, T.S Misra Medical College, Lucknow, Uttar-Pradesh, India from January 2018 to February 2020. A total of 1576 urine samples were collected from different wards of hospitals and Intensive Care Unit (ICU) with age group 0-80 years. Out of 1576 urine samples received, 786 had fungal growth, from which 176 Candida spp. were isolated. Candidauria and Candida UTIs data were collected from Institute's microbiology records retrospectively. The obtained results were statistically analysed in numbers and percentages using MS Excel 2013 version. Result: The prevalence of Candida species was 11.2%. The age group between 21-30 years was more prevalent. Diabetes mellitus was the main co-morbidity factor in Candiduria patients. The incidence rate was high in ICU patients 161 (91.5%) than non ICU patients (8.5%). Most the samples were isolated from general medicine (45.3%) and Obstetrics and Gynaecology department (34.8%) followed by general surgery (15.5%) and pediatric department (4.4%). Conclusion: Present study found the high prevalence of candiduria and the isolates were biofilm producers with increasing resistance against most common drugs fluconazole which is a major concern for the treatment and management aspects. In immunocompromised patients, it is important to identify the species of Candida isolates as well as their antifungal susceptibility pattern to assist the clinicians in treating the patients with candiduria.