Identification of Candida Species Isolated from Hospitalized Patients with Candiduria

Background and objectives: The incidence of candiduria caused by Candida spp. has increased in recent years, particularly in hospitalized patients. Candiduria is most commonly caused by Candida albicans; however, an increase in the prevalence of non-albicans species has been observed during last decades. This study aimed at molecular identification of Candida species isolated from candiduria in hospitalized patients. Methods: This cross-sectional study was conducted on 530 hospitalized patients in two hospitals in the Mazandaran Province, Iran. Midstream urine specimens were collected and then cultured on CHROMagar Candida medium. Molecular identification of common Candida species was carried out using the polymerase chain reaction-restriction fragment length polymorphism method after enzymatic digestion with MspI. C. albicans and Candida parapsilosis species complexes were identified by amplification of the HWP1 and intein-containing vacuolar ATPase precursor genes, respectively. Results: The frequency of candiduria was estimated at 14% among hospitalized patients. Of 74 samples positive for candiduria, 65 (87.8%) were isolated from females. The most common predisposing factor to candiduria was diabetes (n=36; 48.6%). The most frequent isolates were C. albicans complex (n=44; 59.4%), followed by Candida glabrata (n= 16; 21.6%), Candida tropicalis (n= 10; 13.5%), Candida Krusei (n= 3; 4%) and C. parapsilosis (n= 1; 1.3%). Conclusion:  Based on the results, the conventional and molecular methods produced similar results for identification of Candida species. However, accurate identification of Candida spp. requires the use of molecular techniques such as PCR-RFLP, HWP1, and intein-containing vacuolar ATPase precursor genes. Nevertheless, chromogenic methods such as CHROMagar Candida can be used for diagnosis of Candida spp. in laboratories with limited resources.