Unveiling the Clinical Correlation between Candida Tropicalis Presence,Symptomatology and Urinary Yeast Quantification in Diabetic Patients

Authors

Abstract

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.

Methods

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

Published

2026/03/04

Issue

Vol. Volume 7-issue 1

This work is licensed under a Creative Commons Attribution-Non-Commercial 4.0 International License .

This is an open-access journal and all the published articles / items are distributed under the terms of the  Creative Commons Attribution BY-NC 4.0 License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments psimjournal@gmail.com