2014 – Yeasts isolated from nosocomial urinary infections Antifungal susceptibility and biofilm production

Background: Urinary Candida infections in the hospital environment are frequent and need to be betterunderstood.Aims: To compare the results of antifungal susceptibility profiles of yeasts isolated from patients withurinary infections obtained by broth microdilution method (BM) and by disk diffusion (DD), and alsoevaluate the capacity of these yeasts to form biofilms.Methods: Only yeasts obtained from pure urine cultures with counts higher than 105colony-formingunits per milliliter, without bacteria development, of symptomatic patients were included. The isolateswere identified by classical methods and the antifungal susceptibility tests were performed with thefollowing drugs: amphotericin B, ketoconazole, fluconazole, itraconazole, voriconazole and caspofungin.The biofilm studies were carried out in polystyrene microtitration plates.Results: Ninety-five yeasts isolates were analyzed, including 40 Candida albicans, 31 Candida glabrata, 24Candida tropicalis. In general, the majority of the isolates were susceptible to the tested drugs but someresistance was observed, especially against fluconazole. Great variability in the antifungal susceptibilityresults was observed with the different tested drugs and a few discrepancies were observed between bothmethods. We suggest that in case of DD resistance this result should be confirmed by BM, the standardmethod. C. tropicalis isolates showed high biofilm production (91.7%) compared to C. albicans (82.5%) andC. glabrata (61.3%), with statistical significance (p = 0.0129).Conclusions: Candiduria in critical patients requires major attention and a better control. The differ-ent susceptibility results obtained in this study showed the need to identify yeasts up to the specieslevel, especially in patients with urinary tract infection. The development of techniques of antifungalsusceptibility tests can help the clinicians in the empiric treatment of candiduria.


Yeasts isolated from nosocomial urinary infections Antifungal susceptibility and biofilm production


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