<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.2d1 20170631//EN" "JATS-journalpublishing1.dtd">
      <Volume-Issue>Volume 11, Issue 2</Volume-Issue>
      <Season>October - December 2020</Season>
          <FirstName>Ramya R</FirstName>
          <FirstName>Shajahan O. M</FirstName>
      <Abstract>Aim: The aim is to speciate Candida isolated from the urine samples of hospitalized patients, to correlate risk factors associated and to find out the Antifungal susceptibility of the Candida species isolated. Methods: This is a single centre, cross – sectional study with study group of 100 hospitalized patients with candiduria having a colony count of more than 10 4/ml of urine. Patients satisfying the inclusion criteria were interviewed by structured questionnaire and their hospital records were used to know about the history, risk factors, duration of Candiduria and treatment details. Results: A total of 100 patients were included in the study, Males constituted 54% and females 46% of the total population, with asymptomatic presentation 46%, symptomatic 25% and unconsciousness (patients unable to voice their symptoms), 29%. Fever (17%) and dysuria (13%) were the common symptoms in patients with candiduria. C.albicans constituted 14% and non-albicans Candida spp. constituted 86% of the total isolates obtained. Study showed Hi-Chrom agar was the best method of speciation, compared to Sugar Assimilation Test (SAT) using Rapid identification kit. Hi-chrom agar showed 100% sensitivity while SAT showed only 86% of sensitivity. Resistance to fluconazole was seen in 34% of isolates, with C.tropicalis being the most resistant (14%).72% isolates were susceptible to itraconazole. 90% of the isolates were susceptible to amphotericin B. Conclusion: The increase in rates of resistance particularly among the non-albicans Candida spp. emphasizes the need for speciation and antifungal susceptibility testing. Hence the present study was conducted to speciate Candida isolated from the urine samples of hospitalized patients, to correlate risk factors associated and to find out the Antifungal susceptibility of the Candida species isolated.</Abstract>
      <Keywords>Candiduria, Speciation, Hi-Chromagar, SAT, Risk factors, Antifungal susceptibility</Keywords>
1. Horvath LL, Hospenthal DR, Murray CK, Dooley DP. Direct isolation of Candidaspp. From blood cultures on the chromogenic medium CHRO Magar Candida. J Clin Microbiol. 2003;41:2629-32&#13;
2. Magill SS, Swobodac SM, Johnson et al. The association between anatomic site of Candida colonization, invasive candidiasis and mortality in critically ill surgical patients .Diagnosis Microbiological Infections 2006;55: 293-301.&#13;
3. Sobel JD 1999. Management of asymptomatic Candiduria. Int J Ant Agents 11: 285-288.&#13;
4. Tammy Lundstrom and Jack Sobel, Nosocomial Candiduria :Areview,&#13;
Arasi Samyuktha. et al., Ident i ficat ion, Speciat ion and Ant i fungal suscept i bi l i t y Pat tern&#13;
candida species&#13;
National Journal of Basis Medical Science / Volume 11 / Issue 2 / 2020 Oct-Dec 208&#13;
Clinical Infectious Diseases 2001:32: 1602-07&#13;
5. Carrillo-Muand;ntilde;oz, A.J.; Quindand;oacute;s, G.; Cand;aacute;rdenes, C.D. et al. (2001). Evaluation of Chromalbicans Agar for presumptive identification of Candida albicans. Rev Iberoam Micol 18: 105-8.&#13;
6. Pfaller MA, Diekema DJ, Jones RN, Messer SA, Hollis RJ. Trends in antifungal susceptibility of Candida spp. isolated from pediatric and adult patients with bloodstream infections: SENTRY Antimicrobial Surveillance Program, 1997 to 2000. J Clin Microbiol2002;40:852-6.&#13;
7. Chakrabarti A, Mohan B, Shrivastava SK, Marak RS, Ghosh A, Ray P. Change in distribution and antifungal susceptibility of Candida species isolated from Candidaemia cases in a Tertiary care centre during 1996-2000. Indian J Med Res 2002;116 :5-12.&#13;
8. Xisto Sena Passos, Werther Souza Sales, Patrand;iacute;cia Jackeline Maciel, Carolina Rodrigues Costa, Karla Carvalho Miranda, Janine de Aquino Lemos, Candida colonization in intensive care unit patients’ urine;Rio de Janeiro, Vol. 100(8): 925-928, December 2005.&#13;
9. Odds, F. C. 1993. Resistance of Yeast to azole-derivate antifungals. J. Antimicrob. Chemother. 31:46–71.&#13;
10. Chaudary U, Deep A, Chabbar N. Rapid identification and antifungal susceptibility pattern of Candida isolates from critically ill patients with candiduria. J Infect Dis Antimicrob Agents. 2009;26:49-53.&#13;
11. Arlene O. Cantillep, M.D., Julius A. Lecciones, M.D., Jose S. Almario, M.D., Madel Espinosa, M.D., Thelma E. Tupasi, M.D. and Eileen Navarro-Almario, M.D. Positive Urine Cultures for Candida albicans in 55 patients at Makati Medical Center: Implications for Management :Philippine Journal of Microbiology and Infectious Diseases;Volume 24 Number 2(1995).&#13;
12. S. Krcmery, M. Dubrava, V. Krcmery Jr, Fungal urinary tract infections in patients at risk; International Journal of Antimicrobial Agents, 1999, 289-291.&#13;
13. Paul A.Tambyah, MBBS; Dennis G.Maki, MD, Catheter associated urinary tract infection is rarely symptomatic.A Prospective Study Of 1497 Catheterized Patients. Arch Intern Med/ Vol 160, Mar 13, 2000, 678-682.&#13;
14. Cl´audia Castelo BrancoArtiaga Kobayashi, Orionalda de F´atimaLisboaFernandes, Karla&#13;
Carvalho Miranda, Efigand;ecirc;niaDantas de Sousa and;Maria do Ros´ario Rodrigues Silva;Candiduria in hospital patients: A study Prospective; Mycopathologia 158: 49–52, 2004&#13;
15. Stephen P.storfer, Gerald medoff, Victoria J. Fraser, William G.Powderly and W. M. Claiborne dunagan, Candiduria retrospective review in hospitalized patients: Infectious Diseases In Clinical Practice, 1994;3:23-29.&#13;
16. Uma Chaudhary, Antariksh Deep, NarendarChabra; rapid identification and antifungal susceptibility pattern of Candida isolates from Critically Ill Patients with Candiduria. Journal of Infectious diseases and Antimicrobial agents;may-aug 2009,Vol 26,No 2.&#13;
17. Manisha Jain ,VinithaDogra,Bhibavati Mishra, Archana Takur, Poonam Sood Loomba, ,AradhanaBhargava:Candiduria in catheterized intensive care unit patients –Emerging Microbiological Trends;Indian Journal of Microbiology and Pathology: July to Sep 2011,54(3),pg 552,-5.&#13;
18. Elza Helena Da Silva, L.D.S. Ruiz, F. E. Matsumoto, M. E. Auler, M. C. Giudice, D. Moreira, W. Szeszs and; C.R. Paula; Candiduria in a public hospital of Sand;atilde;o Paulo (1999-2004):&#13;
Characteristics of the Yeast Isolates .Rev. Inst. Med. Trop. S. Paulo 49(6):349-353, November-December, 2007.&#13;
19. N. Febre´, V. Silva, e. A. S. Medeiros,s. B. Wey, a. L. Colombo, and o. Fischman; Journal of Clinical microbiology, Microbiological Characteristics of Yeasts Isolated from Urinary Tracts of Intensive Care Unit Patients Undergoing Urinary Catheterization. May. 1999, p. 1584–1586, vol 37, no 5.&#13;
20. Platt R, Polk BT, Murdock B et al.Risk Factors Of Nosocomial Urinary Tract Infection ,Am J Epidemiology 1986:124:977.&#13;
21. Mohammed A. Al-Fattani and L. Julia Douglas; Biofilm matrix of Candida albicans and Candida tropicalis: Chemical Composition and Role in Drug Resistance; Journal of Medical Microbiology (2006), 55, 999–1008.&#13;
22. YucesoyM ,Esen M, Yulung N. Use of chromogenic media for the identification Candida albicans. Kobe J Med Sci: 2001: 47 :101-7.&#13;
23. Willingertt B, Manafi M. Evaluation of CHROM agar candida for rapid screening of clinical specimens for candida species, Mycoses 1999: 42: 61-5.&#13;
24. Baradkar VP, Mathor M, Kumar S. Hichromspecies.o J patholMicrobiol 2010: 53:93-5.&#13;
25. AnjanaGopi, Neetha S, Murthy, “Presumptive identification of Candida species by using chromogenic agar in comparison with yeast identification protocol in a tertiary care hospital”. Journal of Evidence based medicine and Health care:Volume issue 13, Dec 01,2014, pg:1604-1613.&#13;
26. Yucesoy M, Marol S. Performance oh CHROM agar Candida and BGGY agar for the identification of yeast species. Annals clin Microbiol Antimicrobial 2003:2:1-8.&#13;
27. Willinger B, Hillowoth C, Selitsch B, Nanafi M. Performance of Candida, a new chromogenic medium for presumptive identification of Candida species in comparison to CHROM agar candida. J. Clin Microbiol.2001:39(10):3793-3795.&#13;
28. C.L.Sai, J.L Hsiu, P.F.Chang, L.Xling, C.S.Lai, Disk diffusion test and E test with enriched Mueller Hinton Agar for&#13;
determining the susceptibility of Candida species to Voriconazole and fluconazole, J Microbiol Immunol infect. 42(2009) 148-153.&#13;
29. J D Sobel, Vulvovaginal candidiasis, Lancet, Jun 9:369 (2007) 1961-71.&#13;
30. K.M.Killani, P.J.Joshi, SJ Mehta, Species distribution and antifungal susceptibility pattern in the cases of vulvovaginal candidiasis in sarashtra region of Gujarat, Electronic Journal of pharmacology and therapy Jan (2010).&#13;
31. R.M.Saldanha, Dominic.D, Shivanand. Species identification of Candida isolates in various clinical specimens with their antifungal susceptibility patterns, Journal of clinical and diagnostic research.(suppl-1),vol-5(6) (2011) 1177-1181.&#13;
32. T.Noake, T.Kuriyama, P.L.White, Antifungal susceptibility to Candida species using clinical and laboratory standards institute disk diffusion and broth microdilution methods. J Chemother. Jun: 19(3) (2007) 283-7.</References>