<i>Candida</i> Species in Nephrology Patients: Pathogenic Factors, Genotyping and Antifungal Susceptibility

Abstract

Background: Candiduria is a common manifestation of candidiasis and may be asymptomatic in critically ill individuals. Nosocomial infections such as candiduria are particularly relevant in patients with renal conditions. Identifying virulence determinants in these organisms is essential for clarifying disease mechanisms and informing antifungal therapy. Molecular typing studies are also important for elucidating the epidemiological patterns of infection. Objectives: This study evaluated the prevalence of candiduria among nephrology patients, with an emphasis on pathogenic determinants and the molecular genotyping of Candida isolates. Methods: A total of 245 individuals hospitalized in the nephrology ward were screened for candiduria. Candida species were detected using CHROMagar Candida and confirmed by PCR sequencing. Biofilm production, enzymatic activity, and antifungal susceptibility profiles of the Candida isolates were assessed using specific methods. In addition, ABC genotyping was performed for the molecular typing of C. albicans strains. Results: A total of 44 Candida isolates were obtained from patients, with Nakaseomyces glabratus predominating. Among the enzymatic properties assessed, phospholipase production was the most frequent activity, detected in 84.1% of isolates. Candida albicans exhibited the greatest biofilm-forming potential (64.7%). Antifungal resistance was limited to caspofungin and was observed in 31.8% of the isolates. Genotype A was the predominant type among the C. albicans isolates subjected to genotyping. Conclusions: The predominant pathogen isolated in this study was N. glabratus. The ability of Candida species to secrete enzymes and form biofilms plays a key role in their virulence, particularly in urinary tract infections.