Primary isolation of Candida species from urine specimens using chromogenic medium

CHROMagar Candida (CaC) is a chromogenic medium that can be used to detect Candida species, including Candida albicans, Candida krusei, Candida tropicalis, and perhaps Candida glabrata. We evaluated the utility of CaC to detect candiduria in high-risk patients and the potential usefulness of this information in directing initial antifungal therapy in those later identified with candidaemia. CaC was compared in parallel to standard laboratory methods (SM) for the detection of Candida from urine collected from high-risk units and wards. Of 893 samples, Candida was recovered by CaC from 104 compared with 35 using SM. No isolates detected by SM were undetected by CaC. More than one Candida species were recovered by CaC in 19 of the 104 (18.3%); only two mixed cultures were detected by SM. The identification was more rapid with CaC. Five of 69 patients with candiduria detected by CaC developed candidaemia on or after the date of urine culture. SM recovered fungus in only two of these patients. CaC can be used as primary media for the detection of Candida species from urine specimens. Primary isolation by CaC may enable clinicians to make earlier, directed selection of antifungal agents and potentially reduce patient morbidity and mortality.