Catheter associated Candiduria among in-patients accessing care in a Tertiary Health Institution in Calabar, Nigeria.

Abstract

Urinary tract infections caused by Candida species are becoming increasingly common in hospital settings. The association is higher in patients with urinary catheterization. The aim of this study was to determine the prevalence of Candida species causing urinary infection in catheterized patients in University of Calabar Teaching Hospital and the ability of isolates to form biofilm. The study was a cross-sectional prospective study which ran for five months, from March to August, 2021. Catheterized patients from surgical ward and orthopedic wards were recruited for the study. Purposive sampling method was used because the subjects were few. Urine samples were obtained from the catheter port and subjected to microscopy, culture and susceptibility testing. Candida isolates were characterized and tested for antifungal susceptibility and biofilm production. The study recorded (25.7%) prevalence of candiduria among subjects. Most of the Candida isolates (55.5%) were non-albicans Candida species. Candida albicans accounted for (44.4%) infections. The infection rates among female subjects 7(77.7%) was higher than males 2(22.2%) but there was no significant association between gender and infection rates (χ² = 3.88; p ≥ 0.05). Patients with highest Candida infection (55.6%) were aged 41-50 years while subjects in their first to third decade of life had no infection. Candida glabrata was the highest occurring non-albicans Candida species (33.3%). In this study biofilm production was seen in (66.7%) of the Candida isolates and the isolates were highly susceptible to Itraconazole (100.0%) and Fluconazole (77.3%). Only Candida glabrata was resistant to Amphotericin B (0.0%). Candiduria is a health problem in the study setting among catheterized subjects. Candida albicans was the most isolated Candida species with high rates of biofilm production. There was high antifungal resistance among isolates which calls for better antifungal stewardship for better patients' management and outcome.