Background and Objectives: Candiduria is a common health problem especially among hospitalized patients. In the era of rising azole resistance, evidence from Saudi Arabia remains limited concerning Candida species. This study aimed to assess the prevalence and risk factors of Candida isolated from urine culture and to explore species distribution in relation to clinical characteristics. Materials and Methods: We retrospectively reviewed 188353 urine samples from 2013 to 2023. Using medical records, data on age, gender, hospitalization status, and urine sample type were collected. Identification of Candida species was performed by VITEK Mass Spectrometry (bioMerieux Inc.). Binary logistic regression analysis was used to identify predictors of candiduria. A p value below 0.05 at a 95% CI was considered statistically significant. Results: A total of 1667 urine samples with significant Candida growth were reported. It accounted for 0.88% of all organisms grown from urine culture and 30% of Candida grown from various body sites. Candida albicans was the most frequently identified species (n = 920, 55.2%), followed by C. tropicalis (n = 374, 22.4%), C. krusei (n = 80, 4.8%), C. glabrata (n = 78, 4.7%), and C. parapsilosis (n = 41, 2.5%). However, the rate was not stable throughout the years, and non-albicans Candida (NAC) was often the most prevalent. Female gender was the strongest predictor of candiduria (OR and AOR 1.81, 95% CI 1.46–2.25), whereas significantly lower odds were seen in elderly patients and in random urine specimens. The species distribution of NAC did not seem to change with age, gender, type of specimen, or hospitalization status. Conclusions: Among all Candida spp. isolated in the lab, 30 out of every 100 originated from urine culture, with a significant risk associated with females. The increasing prevalence of emerging Candida species in tertiary care settings can provide clinicians with valuable insights for the diagnosis and management of Candida UTI.
Alghamdi et al. (Sat,) studied this question.