Urinary tract infections (UTIs) caused by fungi, frequently associated with medical devices, have increased and caused great morbidity and mortality among hospitalized patients. Difficulties on different species identification as well as the lack of standardized sensitivity tests in vitro, contribute to the limited information available on epidemiology, diagnosis, and
therapeutics of
Trichosporon infections. There are only sporadic reports of UTI caused by Trichosporon asahii reported from India. We report six cases of UTI caused by T. asahii in severely ill patients in a tertiary care setup. Among six positive T. asahii UTI, four were found in female patients with a mean age of 60 years. We observed that all patients were on indwelling
urinary catheter, broad-spectrum
antibiotics, and with other comorbid conditions. With regard to the antifungal susceptibility testing, all the isolates were resistant to
amphotericin B and sensitive to
voriconazole. Majority of them were sensitive to
Itraconazole, half of them were sensitive to
fluconazole. The ubiquity and biofilm formation poses difficulty in establishing pathogenicity and delineating environmental or
nosocomial infections. Risk factors such as use of
antibiotics,
indwelling catheter, and comorbidities such as
hypertension, diabetes,
anemia, and
chronic kidney disease predispose for the development of UTI by T. asahii. Isolation of the same yeast in three consecutive urine samples with significant counts, along with significant number of
pus cells establishes T. asahii as an etiological agent of UTI. Furthermore, the clearance of the fungus from the urinary tract with the recovery of the patient following
catheter removal and antifungal
therapy further confirms T. asahii as the cause of UTI.