PTU - Polskie Towarzystwo Urologiczne
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CODE: 5 - Fungal urinary tract infections in hospitalized patients
Article published in Urologia Polska 2006/59/Suplement 1.


Alicja Rokosz, Katarzyna Kot, Anna Sawicka-Grzelak, Ewa Swoboda-Kopeć, Sylwia Błachnio, Iwona Serafin, Mirosław Łuczak
Katedra i Zakład Mikrobiologii Lekarskiej AM w Warszawie


Introduction. Fungal urinary tract infections (UTI) may constitute even to 5% of all UTI cases in hospitalized patients. Funguria occurs usually in diabetic patients, immmunocompromised patients and in patient with indwelling catheters. The most frequent cause of this disease are yeast-like fungi from the genus Candida. Among fungal uropathogens Candida albicans strains dominate. However, the contribution of Candida albicans, Candida parapsilosis and Trichosporon asahii to fungal UTI is increasing. Strains of these species may be resistant to many antimycotic agents used in a urologic practice.
Objectives. Isolation, identification and susceptibility testing to antifungal agents of uropathogenic fungal strains cultured from urine samples of hospitalized patients.
Materials and methods. Urine specimens were collected from patients hospitalized in different departments of a university hospital in Warsaw during 18 months. Fungal strains were isolated in cases of significant funguria (>104CFU/ml). Fungal uropathogens were identified in an automatic ATB system (bioMerieux sa) with the use of ID 32 C tests. Susceptibility of strains to antifungal agents: flucytosine, amphotericin B, miconazole, ketoconazole, itraconazole and fluconazole was determined by means of Fungitest (BIO-RAD, France). Reference Candida albicans ATCC 90028 strain was used as control strain in each test.
Results. Fifty two strains of fungal uropathogens were cultured during 18 months. All strains belonged to the group of yeast-like fungi (genera: Candida and Trichosporon). Cases of funguria concerned about 0.5% of patients treated in our hospital. Twenty nine fungal uropathogens were isolated from patients of transplantology departments. Strains of the genus Candida (33/52) dominated among fungi causing urinary tract infections (UTIs). Remaining uropathogens belonged to the species Trichosporon asahii (19/52) and were mostly isolated from patients of transplantology departments (16/19). All Trichosporon asahii strains were susceptible (17) or intermediately susceptible (2) to fluconazole.
Conclusions. Trichosporon asahii (19/52) and Candida albicans (17/52) strains dominated among fungal uropathogens isolated from patients of our hospital in Warsaw. Fluconazole was the most active in vitro agent against fungal strains causing urinary tract infections in hospitalized patients.