Shalini Malhotra
Children with urinary tract infection present with vague clinical features and candiduria in such patients signifies pyelonephritis/cystitis, disseminated candidiasis, contamination or colonisation. This study was aimed to determine the prevalence of candiduria in paediatric patients, their speciation, associated risk factors and antifungal susceptibility of these isolates which will help the clinicians in the better management of candiduria. In our study, the isolation rate for candiduria was 24.3%, more common in males (63%) compared to females (37%) and infants were most commonly involved. Colony count of ≥105 cfu/ml seen in 53% of the isolates and pus cells were seen in 84% cases. Among candiduria cases, 87% received broad spectrum antibiotics for more than 7 days, while 57% were catheterized, and 19% of the patients were on fluconazole therapy. In the present study, non-albicans candida species emerged as the predominant pathogen and was found in 57% cases while Candida albicans was found in 43% cases of candiduria. Antifungal susceptibility testing revealed that all the isolates were sensitive to voriconazole and ketoconazole while 95% of the isolates were sensitive to fluconazole and 92% were sensitive to itraconazole. Resistance to fluconazole was found in 5% of isolates while 8% isolates were resistant to itraconazole. Identification of candida species along with antifungal susceptibility is important in patients with UTI and will help the clinician in selecting the appropriate antifungal agent for better management of such cases.
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