Candiduria and Urinary Candidiasis in Basrah, Iraq


Out of 2000 patients with candiduria , 43 patients ( 20 males and 23 females) showed significant candiduria (with about 1x103 - ≥ 1x105 cfu /ml ) and with significant pyuria. These cases were followed and mid-stream urine samples were examined by direct microscopy and by culturing on Sabouraud’s Dextrose Agar(SDA) with the antibacterial antibiotic chloramphenicol. The underlying diseases, sex and age were also recorded . Five Candida species were isolated and identified , C. albicans constituted 51% of the examined cases , followed by C. glabrata (26%), C. tropicalis and C. parapsilosis each constituted 9.3% while Candida sp. constituted 4.65%. Five cases were associated with bacterial pathogens (two with Escherichia coli, two with Pseudomonas aeruginosa and one with Streptococcus viridans). Diabetes mellitus was the most affecting factor (35%), followed by multiple antibiotic users (11.6%), renal stones, renal surgery, cancer and Foley’s catheters each constituted 9.3%. Amphotericin-B (AMP-B), Fluconazole and Ketoconazole showed good activity against Candida isolates. AMP-B showed a wider range of fungistatic levels and 80% (20/25)of the tested strains were inhibited at a concentration of 3.13 µg/ml and 100% inhibition obtained at 12.5 µg/ml. Both fluconazole and ketoconazole showed 100% inhibition at 25 µg/ml, while clotrimazole reach 100% of inhibition at 50 µg/ml. The polyene antibiotic, nystatin showed 80% inhibition at 50 µg/ml. The results of the minimal fungicidal concentration (MFC) are either the same of the minimal inhibitory concentration (MIC) results or of two to four folds or greater.