Acta tropica · 2026
Emerging role of Candida species virulence factors and antifungal resistance in ureteral stent colonization and encrustation.
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Khan Nargis, Faryal Rani
Аннотация
BACKGROUND: Ureteral stents are susceptible to colonization by Candida species, leading to stent-associated infections that are often difficult to treat. This study aimed to identify the Candida species colonizing ureteral stents and to assess the potential impact of their virulence factors on ureteral stent encrustation.
MATERIAL AND METHODS: Candida species and Pseudomonas aeruginosa were isolated and identified from urine and ureteral stent samples. Phenotypic and genotypic detection of virulence factors and antifungal resistance was performed. In addition, the anticandidal activity of Pseudomonas species was evaluated.
RESULTS: Among 25/95 patients, 32 Candida isolates were identified, of which 17 (53.1 %) were from ureteral stents and 15(46.8 %) were from urine samples. Candida albicans and non-albicans were significantly associated with stent colonization (p = 0.00001 and p = 0.000092). A significant association was observed between Candida-positive ureteral stents and concurrent urine culture positivity (p = 0.0153). P. aeruginosa was isolated in 29.5 % of patients, and all exhibited anticandidal activity. A significant inverse association (p < 0.05) was observed between the presence of P. aeruginosa and Candida colonization. Biofilm formation was detected in 51.8 % of stent-derived isolates. Urease activity was higher in ureteral stent isolates (94.1 %) (p = 0.04). Fluconazole and voriconazole resistance was 70 % and 53 % in ureteral stent isolates, and 47 % and 53 % in urine. The ALS1 and Hwp1 genes were detected in 78 % and 93 % of isolates, while the Erg11 gene was detected in 47 % isolates. C. albicans predominated in stent colonization, exhibiting enhanced virulence traits and antifungal resistance. These findings suggest that Candida species associated with ureteral stents contribute to encrustation, potentially complicating treatment and highlighting the need for targeted therapeutic strategies.
MATERIAL AND METHODS: Candida species and Pseudomonas aeruginosa were isolated and identified from urine and ureteral stent samples. Phenotypic and genotypic detection of virulence factors and antifungal resistance was performed. In addition, the anticandidal activity of Pseudomonas species was evaluated.
RESULTS: Among 25/95 patients, 32 Candida isolates were identified, of which 17 (53.1 %) were from ureteral stents and 15(46.8 %) were from urine samples. Candida albicans and non-albicans were significantly associated with stent colonization (p = 0.00001 and p = 0.000092). A significant association was observed between Candida-positive ureteral stents and concurrent urine culture positivity (p = 0.0153). P. aeruginosa was isolated in 29.5 % of patients, and all exhibited anticandidal activity. A significant inverse association (p < 0.05) was observed between the presence of P. aeruginosa and Candida colonization. Biofilm formation was detected in 51.8 % of stent-derived isolates. Urease activity was higher in ureteral stent isolates (94.1 %) (p = 0.04). Fluconazole and voriconazole resistance was 70 % and 53 % in ureteral stent isolates, and 47 % and 53 % in urine. The ALS1 and Hwp1 genes were detected in 78 % and 93 % of isolates, while the Erg11 gene was detected in 47 % isolates. C. albicans predominated in stent colonization, exhibiting enhanced virulence traits and antifungal resistance. These findings suggest that Candida species associated with ureteral stents contribute to encrustation, potentially complicating treatment and highlighting the need for targeted therapeutic strategies.