MOLECULAR TYPING AND FLUCONAZOLE SUSCEPTIBILITY OF URINARY CANDIDA-GLABRATA ISOLATES FROM HOSPITALIZED-PATIENTS

At our community teaching hospital between August 1994 and August 1995 , Candida glabrata accounted for 14% of all Candida isolates and for 3 1% of urinary Candida isolates. The culture site was urine for 68% of C. glabrata isolates compared to 30% of all Candida isolates (p < 0.00 1, chi(2)). To study the association between C. glabrata and isolation from the urine, we analyzed all available C. glabrata urinary isolate s over a 3-month period (23 isolates from 20 patients) using electroph oretic karyotyping, random amplified polymorphic DNA analysis, and flu conazole susceptibility testing. Random amplified polymorphic DNA gene rated eight types, although electrophoretic karyotyping generated 17 t ypes. Combining the two methods resulted in 19 types indicating that u rinary C. glabrata strains at our hospital are genetically diverse and the association between C. glabrata and urinary tract isolation does not appear to be due to horizontal transmission of a single or small n umber of strains. In vitro susceptibility tests showed that C. glabrat a isolates from patients receiving fluconazole had significantly highe r minimum inhibitory concentrations to fluconazole than those not rece iving fluconazole (p < 0.05). Despite a limited number of patients and isolates, our data suggest that selection of less susceptible organis ms by the presence of antifungal agents may be an important contributo r to increased urinary isolation of C. glabrata from patients in our h ospital. (C) 1997 Elsevier Science Inc.