Uropathogenic and antibiotic resistance of Candida species among women visitinga tertiary care hospital in Gaborone, Botswana

Abstract

The present paper aims to determine the prevalence and antibiotic susceptibility of Candida uropathogens among women at a tertiary hospital in Gaborone, Botswana. A total of 180 urine samples were collected from females of different age groups with UTIs from Princess Marina Hospital, Gaborone and assayed for the presence of Candida species. Five species of Candida, namely C. albicans, C. glabrata, C. krusei, C. dubliniensis and C.tropicalis were tentatively identified and antibiotic suceptibility was carried out on chromogenic media using the Vitek 2 system. The identification of these species were confirmed by amplifying the internal transcribed spacer regions (ITS). To amplify the superseding 5.8S ribosomal Deoxyribonucleic Acid (rDNA) and the adjacent ITS1 and ITS2 regions, the ITS1-ITS4 primer pair was used. Candidal uropathogens accounted for 38.8 % of UTIs out of 180 urine samples. Candida albicans was the most predominant in the urine samples acounting for 45.7 % followed by Candida glabrata (17.1 %), while C. krusei and C.dublineinsis each acounted for 10 % and Candida tropicalis 5.5%. There was no statistically significant diferrence (p<0.05) between the rate of isolation of Candida spp. Although a high prevalence of candiduria (51.4%) was associated withfemales in the 26-35 age bracket, this effect was not statistically significant (p<0.05) among different age groups. Three non-Candida species (1.6%), Cryptococcus neoformans, C. albius and Rhodotorulasp were also detected from urine samples. This finding is alarming and demonstrates that these species may emerge as opportunistic pathogens in UTIs. C. dublineinsiswas highly resistant to flucytosine (100%) and fluconazole (60%). The results of the present study highlight a growing problem of antifungal resistance among some Candida uropathogens and call for a need to establish stringent measures in monitoring the same.