Al-Haifi Abdulrahman Y, Al-Shami Ali Salman, Al-Mehdar Ali A, Al-Thamarani Samar M, Saleh Mohammed A
Department of Microbiology, Medical School in Thamar University, Thamar City, Republic of Yemen.
Department of Pharmacy, Medical School in Thamar University, Thamar City, Republic of Yemen.
Int Microbiol. 2025 Apr;28(4):739-749. doi: 10.1007/s10123-024-00578-8. Epub 2024 Aug 19.
The incidence of urinary tract infections associated with Candida is increasing in Yemeni public hospitals.
The primary objective of this research was to isolate specific Candida species responsible for catheter-associated urinary tract infections (UTIs) and to examine the antifungal sensitivity of these Candida isolates.
A total of 200 samples were collected from patients with catheters admitted to multiple hospitals of Thamar city (Yemen). There were 50 positive samples with Candida out of 200 samples. We conducted the primary identification process using the established protocols. Before isolation and identification, all yeast isolates underwent sub-culturing on Sabouraud dextrose agar. We employed the standard microbiological procedures such as Gram staining, colonial morphology analysis, lactophenol cotton blue assay, germ tube formation assessment, colony staining on chrom agar Candida medium, and incubation at 37 °C for 48 h. The assessment of cultures was conducted by evaluating their predominant species. All Candida isolates were tested for antifungal susceptibility using the disk diffusion technique, as indicated by the Clinical and Laboratory Standards Institute (CLSI) M44-A document recommendations.
In this study, the prevalence of Candida species obtained from catheter-associated UTIs was shown to be the highest among individuals aged 51-60 years (28.0%) and the lowest was among those aged 10-20 years (8.0%). Males exhibit higher rates than females, with males accounting for 56.0 and females for 44.0%, respectively. The predominant strain from catheters linked to urinary tract infections was Candida albicans. The Candida isolates had the highest susceptibility to itraconazole, with fluconazole and nystatin at sensitivity rates of 64, 60, and 50%, respectively. Amphotericin B and ketoconazole exhibited the most elevated concentrations. The p value of duration of catheterization < 5 was significant (p = 0.01), as well as significant in anti-fungal susceptibility testing of itraconazole, ketoconazole, and nystatin which are (p = 0.03), (p = 0.04), and (p = 0.03) respectively.
Urinary tract infection due to candiduria was more common in patients with indwelling urinary catheter. The catheter-associated urinary tract infection caused by Candida species occurred mainly in old male patients. Candia albicans was the predominant Candida species isolated from urinary tract infection associated with urinary catheter at Thamar city hospitals. This study determined that diabetes and antibiotic use are significant predisposing factors associated with isolation of Candida in specimens submitted by patients at Thamar city hospitals.
在也门公立医院，念珠菌相关的尿路感染发病率正在上升。
本研究的主要目的是分离出导致导管相关尿路感染（UTI）的特定念珠菌物种，并检测这些念珠菌分离株的抗真菌敏感性。
从也门塔马尔市多家医院收治的留置导管患者中总共采集了200份样本。200份样本中有50份念珠菌阳性样本。我们使用既定方案进行初步鉴定过程。在分离和鉴定之前，所有酵母分离株都在沙氏葡萄糖琼脂上进行传代培养。我们采用了标准微生物学程序，如革兰氏染色、菌落形态分析、乳酚棉蓝试验、芽管形成评估、在念珠菌显色培养基上进行菌落染色以及在37°C下孵育48小时。通过评估其优势菌种来进行培养物评估。所有念珠菌分离株都按照临床和实验室标准协会（CLSI）M44 - A文件建议，使用纸片扩散法进行抗真菌药敏试验。
在本研究中，从导管相关UTI中分离出的念珠菌物种患病率在51 - 60岁个体中最高（28.0%），在10 - 20岁个体中最低（8.0%）。男性患病率高于女性，男性分别占56.0%，女性占44.0%。与尿路感染相关的导管中主要菌株是白色念珠菌。念珠菌分离株对伊曲康唑敏感性最高，对氟康唑和制霉菌素的敏感率分别为64%、60%和50%。两性霉素B和酮康唑的浓度最高。导管留置时间<5天的p值具有显著性（p = 0.01），在伊曲康唑、酮康唑和制霉菌素的抗真菌药敏试验中也具有显著性，分别为（p = 0.03）、（p = 0.04）和（p = 0.03）。
念珠菌尿导致的尿路感染在留置导尿管的患者中更为常见。念珠菌引起的导管相关尿路感染主要发生在老年男性患者中。白色念珠菌是塔马尔市医院从与导尿管相关的尿路感染中分离出的主要念珠菌物种。本研究确定糖尿病和抗生素使用是与塔马尔市医院患者送检标本中念珠菌分离相关的重要易感因素。
