FLUCONAZOLE RESISTANCE IN CANDIDA SPECIES ASSOCIATED WITH CANDIDURIA IN HOSPITALIZED PATIENTS: NARRATIVE REVIEW

Abstract

Candiduria is a relevant finding in hospitalized patients and may be associated with urinary catheter use, previous antibiotic therapy, prolonged hospitalization, diabetes mellitus, immunosuppression, and greater clinical severity. This study aimed to analyze fluconazole resistance in Candida species associated with candiduria in hospitalized patients, considering risk factors, resistance mechanisms, and clinical implications. This is a qualitative and descriptive literature review. The search was conducted in PubMed and SciELO, considering publications from 2023 to 2025 and terms related to candiduria, fluconazole, and biofilm, combined with the Boolean operator AND. Eight scientific articles were included. The studies highlighted nonalbicans species, especially Candida tropicalis, Candida glabrata, and Candida krusei, due to resistance or reduced susceptibility to fluconazole. Resistance mechanisms included alterations in the ERG11 gene, efflux pumps, changes in the ergosterol pathway, and biofilm formation. It is concluded that species identification, antifungal susceptibility assessment, rational use of antifungals, and control of predisposing factors are essential for candiduria management and for reducing potential therapeutic failures in hospitalized patients.