Molecular study of candiduria in pediatric patients in in relation to biofilm formation and fluconazole tolerance.

BACKGROUND

There are limited studies about the presence of Candida species (Candida spp.) and ABC genotypes in hospital acquired urinary tract infection (UTI) in children.

AIM: the study aimed at identification of Candida spp. associated with candiduria in children, detection of fluconazole tolerance and biofilm formation and genotyping of C. albicans.

METHOD: The study was conducted on pediatric patients with hospital-acquired UTI. A urine sample was cultured on the agar CHROM Candida. Molecular identification of Candida spp. was performed by nested polymerase chain reaction (PCR) and specific genotyping of C. albicans was performed by PCR. Biofilm production and fluconazole tolerance were tested for the isolates.

RESULTS

97 children were included. Urinary catheters were inserted reported in 69.1 % of the children and previous antibiotic intake was reported in 34 % of them. The identified species were C. albicans (66 %) followed by Nakaseomyces glabrata (19.6 %), Candida tropicalis (11.3 %) and Candida kruzei (3.1 %). The ability of biofilm formation was 100 %. The Pichia kudriavzevii had a highest significant rate of fluconazole tolerance (66.7%), (P=0.045). Resistance to fluconazole was observed significantly with C. tropicalis (63.6%), (P=0.033). The common genotypes of C. albicans were A (60.9%) and C (39.1%). There was significant capacity of C. albicans genotype C to form strong biofilm (P<0.001).

CONCLUSION

The study found that C. albicans remains the most prevalent species in candiduria. The ability of Candida spp. to form biofilms was 100% among the isolates. Strong biofilm formation being significantly associated with increased fluconazole resistance and C. albicans genotype C.