C. albicans

Emery Haley, PhD, Scientific Writing Specialist

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Clinical Summary

C. albicans is recognized as a classical, biofilm-forming, yeast uropathogen. 
C. albicans is associated with complicated, persistent, and recurrent UTI. 
In symptomatic UTI patients, C. albicans:
- Is not a contaminant (is found in catheter-collected urine specimens).
- Is viable (can grow out on culture).
- Is pathogenic (associated with elevated urine biomarkers of infection).
Reported severe complications of C. albicans UTI include candidemia and urosepsis.

Yeast Characteristics

Growth Requirements

A Yeast (slow growth, prefers yeast extract peptone dextrose medium and acidic pH)

Biofilm Formation

Yes

Nitrate Reduction

Pathogenicity

Colonizer or Pathobiont

Clinical Relevance in UTI

UTIs can be caused by yeasts and Candida yeast species are classically recognized as uropathogens.[1–4] 

Unlike common bacterial uropathogens, viruses do not display nitrate reductase activity, so screening strategies involving urinalysis for nitrite positivity will be false-negative.[5,6] 

C. albicans is primarily seen in complicated, recurrent, and persistent UTIs among high-risk patient populations such as young children, individuals with abnormalities of the urinary tract and/or indwelling catheters, adults with immunocompromising comorbidities including diabetes mellitus, and hospitalized patients admitted to intensive care units.[7–11] C. albicans also exhibits synergy with classical bacterial uropathogens including S. aureus and S. agalactiae.[12] 

In a study of older adult males and females with clinically suspected complicated UTI, C. albicans was detected in both midstream voided and in-and-out-catheter collected specimens indicating that it was truly present in the bladder, not simply a contaminant picked up during voiding.[13]  Furthermore, elevated markers of immune system activation in the urinary tract have been measured from the same clinical urine specimens in which C. albicans was detected, indicating that the presence of C. albicans was associated with an immune response to urinary tract infection.[14–16] 

Severe complications of C. albicans UTI, including candidemia and urosepsis, have been reported.[17,18] 

Together, these findings indicate that C. albicans should be seriously considered as a uropathogen and demonstrate the value of detecting this organism, particularly in individuals with immune compromise, urinary tract abnormalities, or other risk factors for complicated UTI.

Treatment

Evidence of Efficacy (Checkmarks) [4,27–29]: Amoxicillin/Clavulanate, Ampicillin/Sulbactam, Ampicillin, Ceftriaxone, Gentamicin, Levofloxacin, Linezolid, Nitrofurantoin, and Vancomycin.

References

1. Fisher, J.F.; Kavanagh, K.; Sobel, J.D.; Kauffman, C.A.; Newman, C.A. Candida Urinary Tract Infection: Pathogenesis. Clin. Infect. Dis. 2011, 52, S437–S451, doi:10.1093/cid/cir110.
2. Kauffman, C.A.; Fisher, J.F.; Sobel, J.D.; Newman, C.A. Candida Urinary Tract Infections—Diagnosis. Clin. Infect. Dis. 2011, 52, S452–S456, doi:10.1093/cid/cir111.
3. Sobel, J.D.; Fisher, J.F.; Kauffman, C.A.; Newman, C.A. Candida Urinary Tract Infections—Epidemiology. Clin. Infect. Dis. 2011, 52, S433–S436, doi:10.1093/cid/cir109.
4. Fisher, J.F.; Sobel, J.D.; Kauffman, C.A.; Newman, C.A. Candida Urinary Tract Infections—Treatment. Clin Infect Dis 2011, 52, S457–S466, doi:10.1093/cid/cir112.
5. BacDive | The Bacterial Diversity Metadatabase Available online: https://bacdive.dsmz.de/ (accessed on 11 February 2025).
6. BioCyc Pathway/Genome Database Collection Available online: https://biocyc.org/ (accessed on 11 February 2025).
7. Odabasi, Z.; Mert, A. Candida Urinary Tract Infections in Adults. World J Urol 2020, 38, 2699–2707, doi:10.1007/s00345-019-02991-5.
8. Talapko, J.; Meštrović, T.; Škrlec, I. Growing Importance of Urogenital Candidiasis in Individuals with Diabetes: A Narrative Review. World J. Diabetes 2022, 13, 809–821, doi:10.4239/wjd.v13.i10.809.
9. Ekinci, F.; Yildizdas, D.; Horoz, O.O.; Gundeslioglu, O.O.; Alabaz, D. Treatment of Candida Urinary Tract Infections with Micafungin in Children. Pediatr. Int. 2022, 64, e15033, doi:10.1111/ped.15033.
10. Behzadi, P.; Behzadi, E.; Ranjbar, R. Urinary Tract Infections and Candida Albicans. Cent. Eur. J. Urol. 2015, 68, 96–101, doi:10.5173/ceju.2015.01.474.
11. Gharaghani, M.; Rezaei‐Matehkolaei, A.; Hardani, A.K.; Mahmoudabadi, A.Z. Genotypic Diversity and Antifungal Susceptibility Pattern of Candida Albicans Species Isolated from Hospitalized Paediatric Patients with Urinary Tract Infection in Iran. J. Appl. Microbiol. 2021, 131, 1017–1027, doi:10.1111/jam.15006.
12. Gaston, J.R.; Johnson, A.O.; Bair, K.L.; White, A.N.; Armbruster, C.E. Polymicrobial Interactions in the Urinary Tract: Is the Enemy of My Enemy My Friend? Infect Immun 2021, 89, doi:10.1128/iai.00652-20.
13. Wang, D.; Haley, E.; Luke, N.; Mathur, M.; Festa, R.; Zhao, X.; Anderson, L.A.; Allison, J.L.; Stebbins, K.L.; Diaz, M.J.; et al. Emerging and Fastidious Uropathogens Were Detected by M-PCR with Similar Prevalence and Cell Density in Catheter and Midstream Voided Urine Indicating the Importance of These Microbes in Causing UTIs. Infect. Drug Resist. 2023, Volume 16, 7775–7795, doi:10.2147/idr.s429990.
14. Haley, E.; Luke, N.; Mathur, M.; Festa, R.A.; Wang, J.; Jiang, Y.; Anderson, L.A.; Baunoch, D. The Prevalence and Association of Different Uropathogens Detected by M-PCR with Infection-Associated Urine Biomarkers in Urinary Tract Infections. Res. Rep. Urol. 2024, 16, 19–29, doi:10.2147/rru.s443361.
15. Akhlaghpour, M.; Haley, E.; Parnell, L.; Luke, N.; Mathur, M.; Festa, R.A.; Percaccio, M.; Magallon, J.; Remedios-Chan, M.; Rosas, A.; et al. Urine Biomarkers Individually and as a Consensus Model Show High Sensitivity and      Specificity for Detecting UTIs. BMC Infect Dis 2024, 24, 153, doi:10.1186/s12879-024-09044-2.
16. Parnell, L.K.D.; Luke, N.; Mathur, M.; Festa, R.A.; Haley, E.; Wang, J.; Jiang, Y.; Anderson, L.; Baunoch, D. Elevated UTI Biomarkers in Symptomatic Patients with Urine Microbial Densities of 10,000 CFU/ML Indicate a Lower Threshold for Diagnosing UTIs. MDPI 2023, 13, 1–15, doi:10.3390/diagnostics13162688.
17. Wu, Y.; Li, P.; Huang, Z.; Liu, J.; Yang, B.; Zhou, W.; Duan, F.; Wang, G.; Li, J. Four-Year Variation in Pathogen Distribution and Antimicrobial Susceptibility of Urosepsis: A Single-Center Retrospective Analysis. Ther. Adv. Infect. Dis. 2024, 11, 20499361241248056, doi:10.1177/20499361241248058.
18. Elbaz, M.; Chikly, A.; Meilik, R.; Ben-Ami, R. Frequency and Clinical Features of Candida Bloodstream Infection Originating in the Urinary Tract. J. Fungi 2022, 8, 123, doi:10.3390/jof8020123.
19. Pappas, P.G.; Kauffman, C.A.; Andes, D.R.; Clancy, C.J.; Marr, K.A.; Ostrosky-Zeichner, L.; Reboli, A.C.; Schuster, M.G.; Vazquez, J.A.; Walsh, T.J.; et al. Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis 2016, 62, e1–e50, doi:10.1093/cid/civ933.

About the Author

Dr. Emery Haley is a scientific writing specialist with over ten years of experience in translational cell and molecular biology. As both a former laboratory scientist and an experienced science communicator, Dr. Haley is passionate about making complex research clear, approachable, and relevant. Their work has been published in over 10 papers and focuses on bridging the gap between the lab and real-world patient care to help drive better health outcomes.

Urologists

Primary Care Physicians

Gastroenterologists

Gynecologists

Medical Directors

Post-Acute Care

Healthcare at Home

Urology Clinic

Immediate Care/Urgent Care

Telemedicine

C. albicans

CHECK BACK SOON FOR OUR FULL BLOG ON THE IMPORTANCE OF CANDIDA ALBICANS

Clinical Summary

Yeast Characteristics

Growth Requirements

Biofilm Formation

Nitrate Reduction

Pathogenicity

Clinical Relevance in UTI

Treatment

References

About the Author

Urologists

Primary Care Physicians

Gastroenterologists

Gynecologists

Medical Directors

Post-Acute Care

Healthcare at Home

Urology Clinic

Immediate Care/Urgent Care

Telemedicine

CHECK BACK SOON FOR OUR FULL BLOG ON THE IMPORTANCE OF CANDIDA ALBICANS

Clinical Summary

Yeast Characteristics

Growth Requirements

Biofilm Formation

Nitrate Reduction

Pathogenicity

Clinical Relevance in UTI

Treatment

References

About the Author

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