Rabiye ALTINBAŞ, Selda ASLAN
The Injector - 2025;4(3):89-98
Objective: This study aimed to improve understanding of the management of such cases by evaluating risk factors in patients with concomitant candidemia and candiduria. Methods: Microbial identification of clinical isolates at the species level was performed using the VITEK(R)2 automated system, and antifungal susceptibility was evaluated using the colorimetric microdilution method. Results: The majority of patients with concurrent candiduria and candidemia were hospitalized in medical intensive care units. Prior antibiotic use was the most frequently observed predisposing factor. A total of 57 episodes of simultaneous candidemia and candiduria were identified. Candida albicans was the most frequently isolated species, whereas non-albicans Candida (NAC) accounted for 68.4% of cases. The majority of Candida isolates were pan-susceptible. Most isolates were susceptible to amphotericin B (7/11, 63.6%), except for Candidozyma auris. Fluconazole resistance was the most frequently identified resistance pattern, detected in all C. auris isolates (11/11, 100%) and in 3 isolates of the C. parapsilosis complex (3/10, 30%). Moreover, 2 isolates of the C. parapsilosis complex (2/10, 20%) exhibited resistance to voriconazole, whereas isolates of C. albicans and C. tropicalis remained susceptible. Additionally, 2 isolates of C. albicans (2/18, 11%) showed resistance to both anidulafungin and micafungin, and 1 isolate of Nakaseomyces glabratus (1/5, 20%) showed resistance to micafungin. Fluconazole was the most commonly used first-line antifungal agent. Mortality was higher among patients with C. albicans candidemia. Conclusion: This study provides further insight into the association between candiduria and candidemia, offering valuable information to guide clinical practice.
