One of the first sites for fungal candida to establish itself is in the urinary tract (kidneys, ureters, bladder, urethra). Antibiotics wipe out the bacteria of the urinary tract leaving a barren terrain for fungal candida and antibiotic-resistent strains of bacteria to establish themselves.

Candida is the most common fungal agent present in urine and the most common contaminant. In the absence of chronic debilitating disease or vascular disease, candiuria may represent colonization or low-grade infection that resolves once the underlying disorder is controlled. Persistent candiduria, which is most common in critically ill patients, may represent a disseminated or more extensive (not only bladder) urinary tract infection (Wise et al., 1999)

Candida albicans infections are opportunistic and range from asymptomatic infections to life-threatening ones.

Patients with renal failure are more frequently at risk of fungal infections than the healthy individuals. The aim of the study was: (1) Evaluation of the prevalence of fungi in biological materials obtained from different ontocenoses from patients with end-stage and chronic renal failure undergoing haemodialysis and conservative treatment, respectively. (2) Species determining of isolated fungal strains and evaluation their morphological and biochemical features with regard to biotyping. (3) Examining the connection between intraspecies features of fungal strains isolated from different ontocenoses of the same patient. The study group comprised 136 persons, including 56 patients with end-stage renal failure dialysed for the mean period of 36.2 (+/- 1.62) months–all patients were on chronic haemodialysis therapy (4 hours sessions, 3 times per week), 50 patients with chronic renal failure undergoing conservative treatment and 30 persons with the negative history of any renal disease–control group. At the moment of the evaluation and collection of samples all patients were in good condition, none of the patients revealed symptoms suggesting possible fungal infection. Material for mycological examinations included washings from the oral cavity and samples of urine and faeces. ..Most strains belonged to the genus Candida 96.9% and the most frequently occurring species was C. albicans (60.3%). Other species from this genus composed 39.7%, among which in 11.8% of cases C. parapsilosis was determined, and the following were: C. guilliermondii and C. humicola–both species isolated in 5.59%, C. glabrata (4.35%), C. rugosa and C. tropicalis (both species were isolated in 2.48%)…The prevalence of fungi in collected biological materials from chronic dialysed patients, treated conservatively and persons from control group was determined at the level of 96.4%, 64.0% and 63.3%, respectively. In all examined groups fungi were found in high percentage in the ontocenoses of oral cavity and gastrointestinal tract; in dialysed patients (40.7%), treated conservatively (34.4%) and in persons with negative history of any renal disease (42.1%).

http://www.ncbi.nlm.nih.gov/pubmed/17912812

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