Candiduria in Catheterized Children’s Patients: Association with UT, In-vitro Biofilm Formation, and Standardized VITEK 2 System for Isolated Candida Species

Abstract

Background: Urinary tract infections (UTIs) by Candida species are becoming a common finding in hospitalized patients. Such association is higher in hospitalized pediatric patientsCandida albicans is the predominant fungal pathogen implicated in UTIs. Objective: This study aimed to demonstrate the prevalence of candiduria in pediatric patients with UTIs, characterize the Candida species involved, and evaluate their susceptibility to antifungal agents. Methodology: Candida species were isolated and identified in urine samples collected from 100 hospitalized children, comprising 76% from Inpatients’ Units and 24% from Outpatients’ Units, who were ranged in age from 25 days to 15 years. The automated VITEK 2 system was employed for both the identification of Candida species and susceptibility testing against various antifungal agents. Biofilm production from both albicans and non-albicans Candida was determined using the microtiter plate method. Results: Non-albicans Candida constituted more than half (52%) of the Candida isolates. A higher incidence of Candida species was observed in male patients from Inpatients’ Units in the 1-5 years age group. Additionally, this study revealed a greater prevalence of Candida species among pediatric patients receiving antibiotic treatment. The seven identified Candida species exhibited varying sensitivity to antifungal agents. Biofilm formation was more prevalent in non-albicans Candida. Conclusion: Candida tropicalis was the most prevalent non-albicans Candida (40%), being the most prolific biofilm producer. Amphotericin B and Micafungin were the drug of choice according to their complete sensitivity pattern.