ABSTRACT
BACKGROUND: The isolation of Candida species in urine in patients admitted in intensive care units who bear a vesical catheter is considered as a sign of bad prognosis. The etiological mechanisms and the appropriateness of administering an antifungal treatment in these patients is controversial. PATIENTS AND METHOD: The prevalence of Candida species in urine and the in vitro susceptibility to fluconazole by means of the E-test were determined in 560 patients admitted in an intensive care unit. RESULTS: In 60 patients (11%) Candida species was isolated in urine after catheter replacement. 56.7% of isolates corresponded toC. albicans, 21.7% to C. glabrata, 15% to C.tropicalis, 5% to C. parapsilosis and 1.7% to C.kefyr. Only two isolates (C. albicans and C. glabrata)had a minimal inhibitory concentration (MIC) >= 64 microgram/ml (which was regarded as resistant) and 91% of strains had a MIC between 0.125 and 8 microgram/ml. MIC 90% for C. albicans and C. tropicalis was 1 microgram/ml,while it was 16 microgram/ml for C. glabrata. C. albicans is the most frequent species isolated in urine in these patients. However,over 40% of cases are found to have non-albicans species,especially C. glabrata and C. tropicalis. The majority of Candida isolates (91%) are sensitive in vitro to fluconazole.
