Korean J Urogenit Tract Infect Inflamm.  2014 Oct;9(2):93-98. 10.14777/kjutii.2014.9.2.93.

Profiles of Yeast Isolated from Urinary Tracts with and without Catheter during 2011-2013

• Ryu JH
• Kim TH
• Kweon OJ
• Lee MK

• KMID: 1732621
• DOI: http://doi.org/10.14777/kjutii.2014.9.2.93

Abstract

PURPOSE
Indwelling urinary catheter is considered the most important risk factor for healthcare-associated urinary tract infection (UTI). The aim of the current study was to compare the prevalence of species distribution and susceptibilities of antifungals against clinical isolates of yeasts from funguria with and without urinary catheter.
MATERIALS AND METHODS
We analyzed 45,839 urine specimens collected from patients between 2011 and 2013. Species identification and antifungal susceptibility test to amphotericin B, fluconazole, voriconazole, and flucytosine were performed using the VITEK 2 system (Biomerieux Inc.).
RESULTS
A total of 1,048 (2.29%) urine specimens were yeast culture positive. The most frequent species was Candida albicans (49.0%), followed by C. tropicalis (18.6%), C. glabrata (12.2%), and Trichosporon asahii (7.2%). C. tropicalis was isolated more frequently in catheterized urine than in voided urine (p<0.05). For C. albicans and C. glabrata, frequencies of non-susceptible to fluconazole or voriconazole were higher in catheterized urine than in voided urine.
CONCLUSIONS
The results of this study suggest the possibility that urinary catheter may influence species distribution of yeast and antifungal susceptibilities. Further investigation is warranted to improve infection control strategies for healthcare-associated UTI.

Keyword

Urinary tract infections; Urinary catheters; Yeasts; Microbial sensitivity tests

MeSH Terms

Amphotericin B
Candida albicans
Catheters*
Fluconazole
Flucytosine
Humans
Infection Control
Microbial Sensitivity Tests
Prevalence
Risk Factors
Trichosporon
Urinary Catheters
Urinary Tract Infections
Urinary Tract*
Yeasts*
Amphotericin B
Fluconazole
Flucytosine

Reference

1. Foxman B. Urinary tract infection syndromes: occurrence, recurrence, bacteriology, risk factors, and disease burden. Infect Dis Clin North Am. 2014; 28:1–13.

2. Jeong JY, Son JH, Kim JI, Jang SH. Changes of causative organisms and antibiotic sensitivity of urinary tract infection in the Southern area of Kyoung-gi Do for recent 4 years. Korean J Urogenit Tract Infect Inflamm. 2010; 5:167–75.

3. Burke JP, Pombo DJ. Healthcare-associated urinary tract infections. Mayhall CG, editor. Hospital epidemiology and infection control. 4th ed.Philadelphia: Lippincott Williams and Wilkins;2012. p. 270–85.

4. Tambyah PA, Halvorson KT, Maki DG. A prospective study of pathogenesis of catheter-associated urinary tract infections. Mayo Clin Proc. 1999; 74:131–6.

5. Nam HJ, Jeong SC, Yi JJ, Lee SD. The difference of microorganism and antibiotics resistance between adults and children with urinary tract infection. Korean J Urogenit Tract Infect Inflamm. 2012; 7:136–41.

6. Oh E, Lee H, Lim HS, Park Y. Epidemiology and resistance patterns of bacterial pathogens in urinary tract infections in the Northern Gyeonggi-do Area during 2007-2011. Lab Med Online. 2013; 3:34–9.

7. Sobel JD. Fungal infections of the genitourinary tract. Anaissie EJ, McGinnis MR, Pfaller MA, editors. Clinical mycology. 2nd ed.Churchill Livingstone;2009. p. 547–59.

8. Kobayashi CC, de Fernandes OF, Miranda KC, de Sousa ED, Silva Mdo R. Candiduria in hospital patients: a study prospective. Mycopathologia. 2004; 158:49–52.

9. Kauffman CA. Candiduria. Clin Infect Dis. 2005; 41(Suppl 6):S371–6.

10. Baron EJ, Thomson Jr RB. Specimen collection, transport, and processing: Bacteriology. Versalovic J, Carroll KC, Funke G, Jorgensen JH, Landry ML, Warnock DW, editors. Manual of Clinical Microbiology. 10th ed.Washington: ASM Press;2011. p. 228–71.

11. Clinical and Laboratory Standards Institute. Reference method for broth dilution antifungal susceptibility testing of yeasts. Approved standard. 3rd ed.CLSI document M27-A3. Wayne, PA: Clinical and Laboratory Standards Institute;2008.

12. Clinical and Laboratory Standards Institute. Reference method for broth dilution antifungal susceptibility testing of yeasts. Fourth informational supplement. CLSI document M27-S4. Wayne, PA: Clinical and Laboratory Standards Institute. 2012.

13. Schappert SM, Rechtsteiner EA. Ambulatory medical care utilization estimates for 2007. Vital Health Stat 13. 2011; 169:1–38.

14. Uckay I, Sax H, Gayet-Ageron A, Ruef C, Muhlemann K, Troillet N, et al. Swiss-NOSO network. High proportion of healthcare-associated urinary tract infection in the absence of prior exposure to urinary catheter: a cross-sectional study. Antimicrob Resist Infect Control. 2013; 2:5.

15. Jeon MH, Park WB, Kim SR, Chun HK, Han SH, Bang JH, et al. Korean nosocomial infections surveillance system, intensive care unit module report: data summary from July 2010 through June 2011. Korean J Nosocomial Infect Control. 2012; 17:28–39.

16. Zarb P, Coignard B, Griskeviciene J, Muller A, Vankerckhoven V, Weist K, et al. National Contact Points for the ECDC pilot point prevalence survey; Hospital Contact Points for the ECDC pilot point prevalence survey. The European Centre for Disease Prevention and Control (ECDC) pilot point prevalence survey of healthcare-associated infections and antimicrobial use. Euro Surveill. 2012; 17:pii: 20316.

17. Magill SS, Edwards JR, Bamberg W, Beldavs ZG, Dumyati G, Kainer MA, et al. Emerging Infections Program Healthcare-Associated Infections and Antimicrobial Use Prevalence Survey Team. Multistate point-prevalence survey of health care-associated infections. N Engl J Med. 2014; 370:1198–208.

18. Pfaller MA, Diekema DJ, Gibbs DL, Newell VA, Meis JF, Gould IM, et al. Global Antifungal Surveillance Study. Results from the ARTEMIS DISK Global Antifungal Surveillance study, 1997 to 2005: an 8.5-year analysis of susceptibilities of Candida species and other yeast species to fluconazole and voriconazole determined by CLSI standardized disk diffusion testing. J Clin Microbiol. 2007; 45:1735–45.

19. Paul N, Mathai E, Abraham OC, Mathai D. Emerging microbiological trends in Candiduria. Clin Infect Dis. 2004; 39:1743–4.

20. Jain M, Dogra V, Mishra B, Thakur A, Loomba PS, Bhargava A. Candiduria in catheterized intensive care unit patients: emerging microbiological trends. Indian J Pathol Microbiol. 2011; 54:552–5.

21. Castanheira M, Woosley LN, Diekema DJ, Jones RN, Pfaller MA. Candida guilliermondii and other species of candida misidentified as Candida famata: assessment by vitek 2, DNA sequencing analysis, and matrix-assisted laser desorption ionization-time of flight mass spectrometry in two global antifungal surveillance programs. J Clin Microbiol. 2013; 51:117–24.

22. Mohandas V, Ballal M. Distribution of Candida species in different clinical samples and their virulence: biofilm formation, proteinase and phospholipase production: a study on hospitalized patients in southern India. J Glob Infect Dis. 2011; 3:4–8.

23. Camacho DP, Gasparetto A, Svidzinski TI. The effect of chlorhexidine and gentian violet on the adherence of Candida spp. to urinary catheters. Mycopathologia. 2007; 163:261–6.

24. Pfaller MA, Diekema DJ. Epidemiology of invasive candidiasis: a persistent public health problem. Clin Microbiol Rev. 2007; 20:133–63.

25. Pfaller MA. Antifungal drug resistance: mechanisms, epidemiology, and consequences for treatment. Am J Med. 2012; 125(1 Suppl):S3–13.