JPSIM Journal of Pakistan Society of Internal Medicine J Pak Soc Intern Med 2709-8729 2710-0804 Pakistan Society of Internal Medicine 10.70302/jpsim.v7i1.2610 jpsim.v7i1.2610 Original Research Unveiling the Clinical Correlation between Candida Tropicalis Presence, Symptomatology and Urinary Yeast Quantification in Diabetic Patients Anwar Sidra sidraanwar45751@import.invalid * Rauf Muhammad Kamran Butt Muhammad Ahmad Raza Shahid Fatima Sikandar Muhammad Muaaz Anwar Ahmad Hameed Latif Hospital, Misirishah branch, Lahore Fatima Memorial Hospital/College of Medicine and Dentistry, Shadman, Lahore, Pakistan University of Engineering and Technology, Lahore *Correspondence: Sidra Anwar (sidraanwar45751@import.invalid) 10 03 2026 2026 7 1 47 51 28 11 2025 13 01 2026 18 02 2026 Copyright © 2026 The Author(s) 2026 The Author(s) https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective

This study investigates the association between candiduria and diabetes mellitus, focusing on the presence of fungal elements in urine, associated symptoms, and the most prevalent Candida species in diabetic patients. It also provides a basis for comparing Vitek with advanced molecular techniques.

 Methodology

This cross-sectional study conducted at a tertiary care setting in Pakistan involved 116 participants recruited through non-probability sampling. The diagnostic workup for urinary tract infections was urinalysis and urine culture and sensitivity. The VITEK 2 System was used for the identification of Candida species and to assess their antifungal susceptibility.

 Results

Involving 116 participants, 36 (31%) males and 80 (69%) females, urine analysis revealed Escherichia coli 56 (48.3%), Enterococcus faecium 16 (13.8%), Candida tropicalis 6 (5.2%), and 38 (32.8%) with no growth. Common symptoms included fever, dysuria, urgency, and lower abdominal pain. The frequency distribution of yeast levels in the study reveals that in many cases, 61 (52.6%) were categorized as "NILL," indicating no yeast presence. "MODERATE" yeast levels were observed in 28 (24.1%) cases, "MANY" in 25 (21.6%), and "FEW" in 2 (1.7%). Chi-square analyses showed no significant association between yeast frequency and gender (χ² = 2.32, p = 0.510), lower abdominal pain (χ² = 1.29, p = 0.733), or urgency to urinate (χ² = 0.39, p = 0.942). However, significant associations were observed with fever (χ² = 11.27, p = 0.010) and dysuria (χ² = 9.98, p = 0.019). Likelihood ratio and linear-by-linear association tests supported these findings.

 Conclusion

High prevalence UTIs are common in patients (especially in females) with type 1 and type 2 diabetes mellitus. The prevalence of Candida species, particularly Candida tropicalis, in our study highlights diverse uropathogens in diabetics; otherwise, Candida albicans is the most prevalent organism causing UTIs. Fungal UTIs in the elderly present challenges. With SGLT2 inhibitors emerging as a major risk factor for fungal urinary infections, it is crucial to consider this complication, especially in patients with cardiovascular disease. The Vitek technique offers a reliable, fast, and cost-effective method in low-income countries.

 Keywords Diabetes Mellitus Urinary tract infection Uropathogens prevalence VITEK Ethics Statement

Ethics committee: Institutional Review Board / Ethics Committee (IRB/EC). Approval number: FMH-04/10/2023-IRB-1322, dated November 16, 2023.

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