Infección de vías urinarias a trichosporon asahii. A propósito de 2 casos / Urinary tract infection to trichosporon asahii. About 2 cases

Introducción: Las infecciones de las vías urinarias constituyen una de las patologías infecciosas más frecuentes tanto en la comunidad como en el ámbito hospitalario En el medio hospitalario se ha observado una alta frecuencia de infecciones asociadas a hongos oportunistas, en su mayoría corresponden a especies de Candida spp. Sin embargo, se aíslan otras especies como Trichosporon, donde predomina la especie asahii, en casos de pacientes inmunodeprimidos o con tratamiento previo de antibioticoterapia. Presentación de Casos Clínicos: Se presentan 2 casos donde se aisló en urocultivos Trichosporon asahii. En ambos casos los pacientes presentaron factores de riesgo y síntomas inespecíficos. Conclusión: La presencia de hongos de forma persistente en el tracto urinario es considerada clínicamente significativa. El tratamiento de la funguria debe basarse en el análisis del paciente, de su estado general y de sus factores de riesgo. Para el tratamiento, se observó que el efecto de los triazoles, fueron los más efectivos en el tratamiento de la infección por T. asahii.

Introduction: Urinary tract infections are one of the most frequent infectious pathologies both in the community and in the hospital setting. In the hospital environment, a high frequency of infections associated with opportunistic fungi has been observed, most of which correspond to species of Candida spp. However, other species such as Trichosporon are isolated, where the asahii species predominates (6,7). Presentation of Clinical Cases: Two cases are presented where Trichosporon asahii was isolated in urine cultures. In both cases, the patients presented risk factors and nonspecific symptoms. Conclusion: The persistent presence of fungi in the urinary tract is considered clinically significant (9,10). The treatment of funguria should be based on the analysis of the patient, his general condition and his risk factors (10). For treatment, it was observed that the effect of triazoles was the most effective in the treatment of T. asahii infection (8)

Fungal profile of funguria cases at a tertiary care hospital in southern India.

Background & objectives: Candida albicans is the most common aetiological agent in funguria cases commonly observed in hospitalized patients. But a few reports are available from India where non-albicans Candida species have accounted for >50 per cent of urinary Candida isolates. We undertook this study to know the fungal profile amongst funguria cases. Methods: A total of 123 consecutive fungal isolates obtained from clinically suspected cases of urinary tract infection from April to September, 2013, were included. Yeast species was identified by standard phenotypic methods. Antifungal susceptibility testing of yeast was performed for fluconazole (25 μg) by disc diffusion method as per Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: The male to female ratio was 0.92. The mean age of patients was 42.7 ± 18.9 yr. C. tropicalis (58.5%) was the most common fungal agent followed by C. albicans (30.1%). Only one isolate of C. tropicalis was resistant to fluconazole. Interpretation & conclusions: C. tropicalis and C. albicans were the predominant fungal pathogens responsible for urinary tract infection. Less resistance to fluconazole observed in the study may be due to restricted use of fluconazole in this area.

Molecular Epidemiologic Study Using Randomly Amplified Polymorphic DNA and Risk Factor Analysis for an Outbreak of Candida tropicalis Urinary Tract Infection / 대한임상병리학회지

BACKGROUND: Recently, we noticed an increased isolation rate for Candida tropicalis from urine of the patients in the intensive care unit (ICU) of the neurosurgery department in our hospital. We inves-tigated the risk factors for funguria and performed randomly amplified polymorphic DNA (RAPD) analysis for the isolates. METHODS: A total of 27 strains including 12 strains of C. tropicalis from the urine of ICU patients collected during a one-month period, 13 strains from other wards than ICU, and 2 control strains were analyzed. RAPD analysis was performed using 2 primers (UBC78 and CD16S). Medical re-cords of the patients were reviewed to determine the risk factors for funguria by C. tropicalis. RESULTS: RAPD analysis showed an identical pattern for all strains of C. tropicalis from ICU patients and a heterogeneous pattern for the isolates from other wards. C. tropicalis funguria of these ICU patients was significantly associated with the use of an urinary catheter (100%, P < 0.001), previous surgery (44%, P < 0.05) and trachostomy (40%, P < 0.05), when compared with those of non-ICU patients. CONCLUSIONS: The identical RAPD pattern of all C. tropicalis strains from ICU patients indicates that they possibly originated from one clone. Through the investigation of risk factors, we can postulate that an urinary catheter might be a source for the outbreaks of urinary tract infections in the ICU. In addition, RAPD analysis might be a very useful test as one of the molecular epidemiologic tools for C. tropicalis funguria.

A Retrospective Study of Funguria / 병원감염관리

BACKGROUND: The incidence of fungal urinary tract infections has increased in the immunocompromized patients. We analyzed urine culture results of St. Mary's Hospital during 28 month period between October 1993 and January 1996 to evaluate the frequency of yeast isolates and to survey the distribution of departments from where yeasts isolated. METHODS: We performed a retrospective analysis of urine culture results. Yeasts were identified by the examination of germ tube production in human serum at 37degrees C and API2OC (BioMerieux, France) yeast strip. RESULT: A total of 1,387 urine cultures were reviewed, of which 164 (11.8%) were isolated as fungi. Candida albicans occurred in 36.5% of the total yeast isolates, C. tropicalis in 35.3%, C. glabrata in 10.9% and Trichosporon beigelii in 0.6%. The incidence of urinary fungal infection increased in 1995 (13.0%) than 1994 (9.1%) (P=0.047). Fifty two percents (85/164) of urinary fungi were isolated from patients in Neurosurgery (NS), where isolation of C. tropicalis was significantly more increased than other departments. In four patients, candiduria progressed to candidemia, which were caused by C. albicans (three patients) and C. glabrata (1 patient). CONCLUSIONS: The isolation rate of yeast species was different in NS and non-NS department. The frequency of isolation of C. albicans increased in non-NS department than NS department, while the frequency of isolation of C. tropicalis increased in NS department than non-NS department. The most common organism was C. albicans and department was Neurosurgery.