[Fungal urinary infection: report no. 1]

Area of Science:

• Medical Mycology
• Infectious Diseases
• Antimicrobial Susceptibility Testing

Background:

• Fungal urinary tract infections (UTIs) are increasingly recognized, often associated with predisposing factors like antibiotic use and indwelling catheters.
• A significant proportion of fungal UTIs involve co-infections with bacteria, complicating diagnosis and treatment.
• Candida species are the most common fungal pathogens in UTIs, but other yeasts like Trichosporon and Torulopsis are also implicated.

Purpose of the Study:

• To identify the spectrum of fungal pathogens causing UTIs in a cohort of patients.
• To investigate the prevalence of bacterial co-infections in fungal UTIs.
• To evaluate the in vitro susceptibility of isolated fungal strains to 5-fluorouracil (5-FU).

Main Methods:

• Isolation and identification of fungal strains from urine samples of 36 patients.
• Determination of predisposing factors for fungal UTIs.
• Co-infection analysis with bacterial isolation.
• Minimum Inhibitory Concentration (MIC) determination of 5-FU using Bact-Morphology Agar medium.

Main Results:

• A total of 115 fungal strains were isolated, with Candida albicans (45 strains) being the most frequent, followed by Candida tropicalis (25 strains) and Trichosporon beigelii (22 strains).
• Sixty percent of fungal isolates (60 strains) were found to co-exist with bacteria, primarily Pseudomonas and Streptococcus species.
• Excellent in vitro activity of 5-FU (MIC < 0.78 µg/ml) was observed against Candida albicans, Candida guillermondii, and Torulopsis glabrata, while poor activity (MIC > 100 µg/ml) was noted for Candida tropicalis, Candida parapsilosis, Trichosporon beigelii, and Trichosporon cutaneum.

Conclusions:

• Candida albicans is the predominant fungal pathogen in the studied UTI cases.
• Bacterial co-infections are common in fungal UTIs, necessitating comprehensive diagnostic approaches.
• The efficacy of 5-FU as an antifungal agent varies significantly among different yeast species, with promising activity against some common UTI pathogens but limited efficacy against others.