Isolation of Candida spp. from urine samples (candiduria) is a common finding in hospitalized patients, especially those with risk factors such as intensive care unit admission, prior broad-spectrum antimicrobial therapy, and indwelling urinary catheters. Interpretation of candiduria relies on clinical and epidemiological data, as it may represent colonization or contamination, but can also indicate infection, other genitourinary pathologies, or even candidemia. This study aimed to retrospectively evaluate the epidemiological profile and antifungal susceptibility of isolates from hospitalized patients with candiduria in a university hospital in Minas Gerais. Yeasts isolated from urine samples of patients with candiduria between March 2021 and January 2023 were evaluated. Secondary data were collected from electronic medical records. Fungal identification was performed using phenotypic methods and MALDI-TOF MS, and isolates were subsequently subjected to commercially available antifungal susceptibility testing. Between 2021 and 2023, 106 yeast isolates were obtained from urine samples of 75 individuals. Most patients were elderly (66.7%), female (75%), hospitalized for prolonged periods in the ICU (41.3%), receiving antimicrobials (97.3%), and had indwelling urinary catheters (90.7%). The mortality rate was 38.7%. The most prevalent Candida species were C. albicans (42.5%), C. glabrata (27.4%), C. tropicalis (16.0%), C. parapsilosis (7.5%), and C. kefyr (2.8%). Antifungal susceptibility testing was performed using the disk diffusion method. The antifungals with the highest resistance rates were fluconazole (34.4%), voriconazole (31.2%), itraconazole (18.3%), and caspofungin (9.7%). C. glabrata showed the highest resistance profile. Proper interpretation of candiduria findings, identification of yeasts from clinical samples, and assessment of antifungal resistance provide valuable information on local epidemiology, guide clinical management, and support appropriate antifungal selection for the treatment of fungal infections.
Soldati et al. (Sun,) studied this question.