Epidemiological profile of funguria in an University Hospital in Oujda, Morocco

Document Type : Original Articles


1 Laboratory of Microbiology, Mohammed VI University Hospital/Faculty of Medicine and Pharmacy, Mohammed I University, Oujda, Morocco

2 Laboratory of Parasitology-Mycology, Mohammed VI University Hospital/Faculty of Medicine and Pharmacy, Mohammed I University, Oujda, Morocco

3 Department of Bacteriology, Mohammed V Military Teaching Hospital/Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco



Background and Purpose: The presence of yeasts in the urine is not synonymous with urinary tract infection since it can result in simple colonization or contamination. Regarding this, it is required to further clarify the epidemiological profile of funguria. Accordingly, the present study was conducted to establish the epidemiology of funguria in the Mohammed VI Teaching Hospital of Oujda, Morocco.
Materials and Methods: This retrospective study was conducted on all urine samples sent for cytobacteriological examination to a microbiology laboratory over a period of 28 months (i.e., from March 2016 to June 2018). After the removal of duplicates, the urine samples were treated according to the recommendations of the medical microbiology standards.
Results: A total of 15,165 urine samples were collected. Urinary colonization accounted for 4.94% (n=749) of cases. The infections of the urinary tract accounted for 5.35% (n=811) of cases. Microbial isolates (n=1,669) in colonization and urinary tract infections were dominated by bacteria (93.47%, n=1,560). Furthermore, the yeasts accounted for 6.53% (n=109) of the isolates. Candida albicans was isolated from 56.88% (n=62) of funguria cases. The risk factors for funguria in our series were essentially old age, admission to intensive care unit, and broad-spectrum antibiotic therapy.
Conclusion: The current level of knowledge about the clinical situations leading to funguria with the improvement and popularization of efficient identification techniques for yeasts other than C. albicans should redress the epidemiology of funguria. This should allow the knowledgeable societies to establish the rules of interpreting the cytobacteriological examination of the urine in case of funguria, as for bacteriuria.


1. Etienne M, Caron F. Management of fungal urinary tract infections. Presse Med. 2007; 36(12 Pt 3):1899-906.
2. Fraisse T, Lachaud L, Sotto A, Lavigne JP, Cariou G, Boiteux JP, et al. Recommendations of the infectious disease committee of the French Association of Urology. Diagnosis, treatment and monitoring candiduria. Prog Urol. 2011; 21(5):314-21.
3. Dhraief S, Trabelsi S, Sellem M, Aloui D, Ismail S, Khaled S. Urinary candidiasis: epidemiology, risk factors and difficulties of interpretation. J Med Mycol. 2016; 26(2):e24-5.
4. Dariane C, Cornu JN, Esteve E, Cordel H, Egrot C, Traxer O, et al. Fungal infections and ureteral material: how to manage? Prog Urol. 2015; 25(6):306-11.
5. Develoux M, Bretagne S. Candidiasis and yeast infections. EMC Malad Infect. 2005; 2(3):119-39.
6. French Microbiology Society. Infections urinaires. 5th ed. Paris: Reference in Medical Microbiology; 2015. P. 165-78.
7. French Microbiology Society. Infections urinaires. 6th ed. Paris: Reference in Medical Microbiology; 2018. P. 181–97.
8. Maleb A, Sebbar EH, Ben Lahlou Y, Frikh M, Arioua Mikou K, Lemnouer A, et al. Urinary cytology: UF-1000i versus microscopic examination, under actual conditions of exercise of a microbiology laboratory. IRBM News. 2017; 38(5):150-4.
9. BrillianceTM UTI agar. Oxoid Microbiology Products. Available at: URL: http://www.oxoid.com/uk/blue/prod_detail/prod_detail. asp?pr=cm0949&c=uk&lang=en; 2020.
10. Maleb A, Lamrabat S, Rifai S, Rahmani N, Bensalah M, Benaissa E, et al. A flowchart is always useful : application to the interpretation of the cytobacteriological examination of urine. Ann Biol Clin (Paris). 2019; 77(5):537-42.
11. Hidri N, Essemilaire L, Guérin F. Accreditation in the bacteriology laboratory. Medical in bacteriology. Paris: Elsevier Masson; 2016. P. 85-103.
12. Bouree P, Dahane N, N’Simba B. Candidurie: ne pas traiter d’emblée. Option/Bio. 2013; 24(499):19-20.
13. Krcmery S, Dubrava M, Krcmery V Jr. Fungal urinary tract infections in patients at risk. Int J Antimicrob Agents. 1999; 11(3-4):289–91.
14. Pihet M, Marot A. Diagnostic biologique des candidoses. Rev Francoph Des Lab. 2013; 2013(450):47-61.
15. Hmida SB, Smaoui F, Koubaa M, Hammami F, Chakroun A, Ayadi A, et al. Les infections urinaires à Candida glabrata: les difficultés thérapeutiques. Med Malad Infect. 2018; 48(4):S124.
16. Agrawal S, Brown CT, Miller S, Grundy C, Kulkarni R. Upper urinary tract fungal infections. Br J Med Surg Urol. 2010;
17. Kauffman CA. Diagnosis and management of fungal urinary tract infection. Infect Dis Clin North Am. 2014; 28(1):61-74.
18. Kauffman CA, Fisher JF, Sobel JD, Newman CA. Candida urinary tract infections-diagnosis. Clin Infect Dis. 2011; 52(Suppl 6):S452-6.
19. Canis F, Cavallo JD, Galinier JL, Ranque S. Chapter 18: urinary tract infections. InREMIC. Reference in medical microbiology. Paris: French Society of Microbiology; 2015. P. 165-78.
20. Odom D, Reno H. Fungal infections in the hospitalized patient. Hosp Med Clin. 2015; 4(3):313-27.
21. Maleb A, Sebbar E, Frikh M, Boubker S, Moussaoui A, El Mekkaoui A, et al. Saccharomyces cerevisiae invasive infection: the first reported case in Morocco. J Mycol Med. 2017; 27(2):266-70.
22. Mizusawa M, Miller H, Green R, Lee R, Durante M, Perkins R, et al. Can multidrug-resistant Candida auris be reliably identified in clinical microbiology lab oratories? J Clin Microbiol. 2017; 55(2):638-40.