Phenotypic and Molecular Characterization of Candida Species in Urine Samples from Renal Failure Patients
Science Journal of Clinical Medicine
Volume 2, Issue 1, January 2013, Pages: 14-25
Received: Dec. 25, 2012; Published: 10, 2013
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Mohammed S. Alhussaini, Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Shaqra University, Saudi Arabia
Noha F. El-Tahtawi, Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Al-Dawadmi, Shaqra University, Saudi Arabia
AhmadM. Moharram, Department of Botany and Microbiology, Faculty of Science,Assuit University,Egypt
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The prevalence of Candida infections of the urinary tract (candiduria)has increased significantly over the past few years due to various predisposing factors especially in hospitalized patients. The predisposing factors frequently asso-ciated with candiduria are urinary tract instrumentation, prior antibiotic use, prolonged hospital stay, extremes of age, di-abetes mellitus, female sex and use of immunosuppressive therapy. The purpose of this study was to apply different diag-nostic techniques for characterization of Candida species in urine samples from renal failure patients using urinary cathe-ters. Results showed that 20 % of renal failure patients were suffering from candiduria. Females were more affected than males (64% versus 36% of culture positive cases). Diabetes mellitus and catheterization were the obvious risk factors. Dif-ferent Candida isolates showed variations in their phenotypic (macroscopic and microscopic) characteristics when cultured on CHROMagar Candida, corn meal agar and bovine serum. Candida albicans was the most common species being isolated from 54% of positive cases. C.krusei (Teleomorph: Pichia kudriavzevii), C. glabrata and C.tropicalis were respectively identified in 24%, 16% and 6% of samples. Positive germ tube test (in serum) and production of chlamydospores (on corn meal agar) were only confined to C. albicans. Sequencing of rRNA gene (18S covering ITS1 and ITS2) confirmed the identification of the four Candida species. In vitro antifungal sensitivity test (disc diffusion method) revealed that all Candida strains were inhibited by Amphotericin-B and Nystatin. Other compounds as Clotrimazole, Itraconazole, Ketoconazole, Tioconazole, Fluconazole and Sertaconazole were effective against 50% - 67% of Candida strains. All isolates of C. glabrata were resistant to Clotrimazole and Sertaconazole.It is highly recommended to follow standard hygienic precautions to avoid cross contamination by Candida during hemodialysis. Complications following candiduria can be avoided by early diagnosis and proper treatment with effective antifungal agents.
Candiduria, Renal Failure Patients, Chromagar Candida, RNA Gene Sequencing
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Mohammed S. Alhussaini, Noha F. El-Tahtawi, AhmadM. Moharram, Phenotypic and Molecular Characterization of Candida Species in Urine Samples from Renal Failure Patients, Science Journal of Clinical Medicine. Vol. 2, No. 1, 2013, pp. 14-25. doi: 10.11648/j.sjcm.20130201.13
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