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Urinary system infections are usually bacterial, however, fungal etiology, particularly Candida spp. are encountered in about 10% of these infections. C.albicans is still the most frequently isolated species in candiduria. This study was aimed to identify the risk factors of candiduria and to determine species distribution of Candida which cause candiduria in hospitalized patients. The study was carried out in a total of 93 hospitalized patients (68 female, 25 male; age range: 17-84 yrs, mean age: 59.5 ± 1.7 yrs) of which 50 presented with candiduria (case group) and 43 with bacteriuria (control group), between January 2009 to December 2009. The most frequently isolated species was C.albicans (n= 32; 64%), followed by C.glabrata (n= 13; 26%), C.tropicalis (n= 4; 8%) and C.krusei (n= 1; 2%). All of the isolates except one, were found susceptible to fluconazole and voriconazole by E-test (AB Biodisk, Sweden), however, C.krusei isolate was resistant to fluconazole and susceptible to voriconazole. The mean hospitalization period and the period of stay in intensive care unit (ICU) of the case group (9.56 ± 9.09 and 4.12 ± 7.05 days, respectively) were found statistically significant compared to control group (4.42 ± 3.71 and 0.53 ± 1.78, respectively) (p0.005). Nosocomial origin of infection was higher in control group (n= 45, 90%) than the case group (n= 30, 69.8%), (p= 0.014). The rate of antibiotic use prior to candiduria in the case group was detected significantly higher (n= 43; 86%) than the controls (n= 14; 32.6%) (p= 0.000). The most frequently used antibiotic prior to candiduria/bacteriuria was the quinolone group of agents both in case and control groups (42% and 21%, respectively). The other risk factors for candiduria found to be higher in the case group than the controls were as follows; presence of urinary system intervention (32% and 0, respectively; p= 0.000), catheter use (76% and 46.5%, respectively; p= 0.003) and immunosuppression history (24% and 9.3%, respectively; p= 0.041). However, there was no significant relationship between candiduria and history of surgical intervention, diabetes mellitus and renal failure (p0.05). In conclusion, rate of candiduria might be reduced by judicious antibiotic use, by implementation of guidelines for urinary catheter use, care and maintenance, and shortening the duration of ICU and hospital stay.

Acinetobacter baumannii is a frequent cause of nosocomial infections in most hospitals. Management of infections caused by these strains is difficult, as the strains often display multiple drug resistance, including carbapenem. Tigecycline which is a glycylcycline derivative has antimicrobial activity against many gram-positive and gram-negative organisms. In this study, in vitro activity of tigecycline and carbapenems against clinical isolates of A.baumannii strains were investigated. A total of 100 A.baumannii isolates were collected from hospitalized patients with documented nosocomial infections [pneumonia (n = 39), surgical wound infection (n = 32), bacteremia (n = 16), catheter infection (n = 6), urinary tract infection (n = 5), peritonitis (n = 1), eye infection (n = 1)] between October 2006 and June 2007. Only one isolate per patient was included to the study. Minimum inhibitory concentrations (MIC) of tigecycline were determined by E-test (AB Biodisk, Sweden). Carbapenem resistance of A.baumannii strains were determined by disk diffusion method. All of the 100 A.baumannii isolates (100%) were found susceptible to tigecycline (MIC values ≤ 2 µg/ml; MIC ranges: 0.032-1.5 µg/ml). Imipenem susceptibility test was performed for 95 strains, and 36 (37.9%) were found sensitive, 18 (18.9%) were intermediate sensitive, and 41 (43.2%) were resistant. Meropenem susceptibility test was performed for 87 strains, and 22 (25.3%) were found sensitive, 9 (10.3%) were intermediate sensitive, and 56 (64.4%) were resistant. Since tigecycline is found quite effective on nosocomial A.baumannii isolates, it may be considered as a treatment alternative in infections caused by carbapenem-resistant Acinetobacter spp.