Aarthy, B (2012) A Study on Urinary Isolates of Candida Species Isolated from Hospitalized Patients with Special Reference to Speciation, Antifungal Susceptibility and Comparison of Rapid and Conventional Methods of Speciation. Masters thesis, Madras Medical College, Chennai.
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Abstract
INTRODUCTION : Candida species are ubiquitous yeasts found as a part of normal flora of Mucocutaneous membranes and alimentary tract of humans. They cause Superficial mucosal infections usually, but can invade tissue and produce life Threatening pathology caused by alteration of immune defenses. The major medical events that caused an increased incidence of Candidial infections in the latter half of twentieth century where, (i) introduction of antibacterial agents with broad spectrum of activity that alters host’s normal microbial flora in favour of fungal invasion and (ii) increased prevalence of Immuno suppressed patients due to chemotherapy and emergence of Acquired Immuno Deficiency Syndrome. Candida species can cause wide range of clinical diseases ranging from Superficial infections of skin, nails and mucosal surfaces to deep seated infections involving various internal organs to disseminated disease. It can cause lower urinary tract infections and renal infection. Lower urinary tract infection (UTI) is frequently seen in association with indwelling catheters and diabetes mellitus. Renal Candidiasis, characterized by microabcesses in cortex can occur due to hematogenous spread. AIMS AND OBJECTIVES : To speciate the Candida isolates from urine of hospitalized patients. To find out the ratio of Candida albicans to non-albicans Candida species. To correlate the risk factors to the Candida species associated. To compare the speciation of Candida isolates using the rapid technique of Chrom agar with the conventional techniques of sugar fermentation and sugar assimilation tests. To find out the antifungal susceptibility of the Candida species isolated. MATERIALS AND METHODS : Statistical analysis was carried out using statistical package for social sciences and episoftware by Statistician. The proportional data were tested using Pearson’s Chi Square Analysis test and Fischer’s exact test. Study group included 100 hospitalized patients with Candiduria having a colony count of more than 10 4/ml of urine. Inclusion criteria: Hospitalized Patients with urine colony count of any Candida species more than or equal to 10 4/ml. Patients older than 12 yrs of age. Both males and females were included. Exclusion Criteria: Candiduria with colony counts less than 10 4/ml of urine. Patients less than 12 yrs of age. Outpatients. Patients satisfying the inclusion criteria were included in the study and after getting informed consent, they were assigned serial numbers. They were interviewed by structured questionnaire and their hospital records were used to know about the history, risk factors, duration of Candiduria and treatment details. CONCLUSION : 100 hospitalized patients in Rajiv Gandhi Government Genral Hospital, both males and females with Candiduria colony count of 104 were included in the study and 105 Candida Spp were isolated. It showed a predominance of non albicans Candida spp of about 86.7%. C.tropicalis (63.8%) was the most common isolate obtained followed by C.albicans (13.3%), C.krusei (7.6%), C.guillermondii (7.6%), C.parapsilosis (5.7%) and C.kefyr (1.9%). C.krusei, intrinsically resistant to Fluconazole was commonly isolated from mixtures. Indwelling urinary catheter was an important associated risk factor for nonalbicans Candiduria. Multiple risk factors like antibiotic therapy, prolonged catheterization, Diabetes, CKD and hemodialysis were present in many patients. Constant surveillance of Candiduria is important as C.tropicalis is more invasive, can lead to fatal Candidemia. Identification of Candida to species level is essential, as it can give an idea to the Clinicians about empirical therapy in emergency situations. Hi-Chrom agar helps in reducing the time for diagnosis, thereby reducing the duration of hospital stay and the cost of treatment. The rising antifungal resistance also demands Anti- Fungal Susceptibility testing a routine in all Microbiology Laboratories due to alarming increase of resistant fungal infection.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Urinary Isolates ; Candida Species Isolated ; Hospitalized Patients ; Special Reference ; Speciation, Antifungal Susceptibility ; Comparison Rapid ; Conventional Methods ; Speciation. |
| Subjects: | MEDICAL > Microbiology |
| Depositing User: | Subramani R |
| Date Deposited: | 03 Aug 2017 01:08 |
| Last Modified: | 03 Aug 2017 01:08 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/1748 |
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