Species Distribution and Antifungal Susceptibility Profiles of Isolates from Women with Nonrecurrent and Recurrent Vulvovaginal Candidiasis

Author(s):  
Joana Rolo ◽  
Paula Faria-Gonçalves ◽  
Tiago Barata ◽  
Ana Sofia Oliveira ◽  
Carlos Gaspar ◽  
...  
2021 ◽  
Vol 30 (1) ◽  
pp. 161-167
Author(s):  
Ghada A. Mokhtar ◽  
Mohamed Sh. Ramadan ◽  
Shymaa Yahia

Background: Vulvovaginal candidiasis (VVC) is regarded as a prevalent vaginal infection and mainly results from Candida albicans. Nevertheless, there has recently been a prominent shift in candidiasis etiology regarding non-albicans Candida (NAC) species with achieving importance. For women with more than three episodes annually are described as recurrent vulvovaginal candidiasis (RVVC). Objectives: To isolate, speciate, and determine the value of antifungal sensitivity pattern of candida species isolated from patients developed (RVVC). Methodology: High vaginal swabs (HVS) were taken from patients with RVVC and cultured on ordinary mycological media. Any significant candida growth was identified and speciated by VITEK 2 system. Their antifungal sensitivity was done by disc diffusion approach governed by CLSI guidelines. Results: A total of 110 Candida species from 250 high vaginal swabs were isolated. Among all candida species isolated from patients with RVCC, C.albicanis accounts for 44% while NAC accounts for 56% with C.glabrata most common species isolated. Voriconazole, amphotericin B, and nystatin showed high sensitivity rates (92 %, 89%, and 84% respectively) on all candida species (C.albicans and NAC) isolated from patients with RVVC. Conclusion: In RVCC there is increase in NAC (56%) with C.glabrata most common species isolated. Voriconazole, Nystatin, and amphotericin B have the best antifungal activity against all spp.


2020 ◽  
Vol 16 (1) ◽  
pp. 46-51
Author(s):  
Mohammad Hassan Minooeianhaghighi ◽  
Marziyeh Sehatpour ◽  
Hossein Zarrinfar ◽  
Tanuka Sen

Background: Recurrent vulvovaginal candidiasis (RVVC) is the second most common cause of genital tract infection in females. Excessive use of fluconazole and other azoles is likely to cause the emergence of the resistant species of Candida. Objective : The purpose of this research was to identify Candida isolates from RVVC and the antifungal effect of fluconazole against them. Methods : In this study, 152 patients with vulvovaginal candidiasis were evaluated for the RVVC form. The Candida isolates were purified using CHROMagar Candida and identified based on the nuclear ribosomal internal transcribed spacer (ITS1-ITS2 rDNA) sequence analysis by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. The antifungal susceptibility of C. albicans isolates against fluconazole was determined according to document M27-A3. Results: Out of 152 patients, 20 cases (13.2%) were identified as recurrent form. The frequencies of the Candida species among the patients with RVVC were C. albicans (n = 16, 80%), C. parapsilosis (n = 3, 15%) and C. tropicalis (n = 1, 5%). The most common clinical sign was vaginal discharge (60%). The mean minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) of fluconazole against Candida isolates were 32 µg/mL and 64 µg/mL, respectively. Conclusion: C. albicans was the dominant cause of RVVC. The Candida isolates showed relatively high resistance to fluconazole in vitro. Vaginal discharge was the most common clinical sign among patients with RVVC.


2020 ◽  
Author(s):  
George Antepim Pesewu ◽  
Patrick Kwame Feglo ◽  
Richard Kwaku Boateng ◽  
Samuel Adetona Fayemiwo

Abstract Vulvovaginal candidiasis (VVC) is a common infection among women of childbearing age, and few of these women experience recurrent vulvovaginal candidiasis (RVVC). The study was aimed at determining the virulent factors, and antifungal susceptibility of the Candida species isolated from women with RVVC attending the Nkawie Government Hospital, Ashanti-Region, Ghana. Over a 6–month period (October 2016 to March 2017), a total of 288 women with RVVC were evaluated. Isolation of the yeast was performed after the inoculation of the vaginal specimens onto Sabouraud Dextrose Agar (SDA), and incubated for 24-48 hours at 37oC. The isolates were identified by standardized conventional methods. The enzymatic activities of esterase, phospholipase, haemolysis and biofilm production were evaluated for the identification of the yeast isolates. Susceptibility to antifungal agents was determined by using the Kirby-Bauer disk diffusion method. Azole resistant isolates were further tested for ERG11 gene which encodes the enzyme (cytochrome P450 lanosterol 14-α-demethylase) by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. Vaginal swabs cultures of 200 women (64.4) from 288 samples yielded Candida species. Candida albicans was the commonest isolated specie (33.0%), followed by Candida glabrata (29.5 %), Candida tropicalis (23.0%), and Candida krusei (15.5%). Hemolysin production, phospholipase enzyme activity, and biofilms formation were found in 84.5%, 83%, 77.5%.of the isolates respectively. Most phospholipase producing Candida isolates also formed biofilms. All Candida spp isolated were susceptible to itraconazole while majority of them were resistant to voriconazole. ERG11 genes were detected in 11.1% of Azole resistant Candida species. There is a significant increase in the rate of antifungal resistance among the Candida isolates to fluconazole and voriconazole. There is need for continuous surveillance as well as antifungal susceptibility testing on the Candida spp to guide therapy. A larger epidemiological study is also advocated to determining the degree of spread of ERG11 genes.


2021 ◽  
Vol 9 (6) ◽  
pp. 225-229
Author(s):  
O.S. Burduniuc ◽  
E.I. Bîrcă ◽  
A.M. Burduniuc ◽  
M.V. Bivol ◽  
O.S. Iacon

Background. Candida species is usually a commensal fungus residing in the vagina, in about 30 %–50 % of healthy adults and remains the most common agent isolated from clinical samples of patients diagnosed with vulvovaginal candidiasis (VVC). Culture is not recommended for all patients on a routine basis but is informative for the exclusion of non-albicans infections resistant to azoles, or recurrent VVC. Identification of Candida species and antifungal susceptibility testing are key elements in the correct management of recurrent VVC. The authors of this paper aimed to study the spectrum of pathogenic Candida species. The antifungal sensitivity patterns of the isolated strains during the years 2017-2019 are also presented. Material and methods. A descriptive study of Candida species distribution and antifungal susceptibility profile was performed. Identification of isolated Candida species was performed by the MALDI-TOF MS, bacterial strains by Vitek 2 automated system (BioMérieux) and antifungal susceptibility profiles by Fungitest (Bio-Rad). Results. Of the 1030 recovered strains, C. albicans species predominated - 83.8% and Candida non albicans -16.2%. The most common species of the Candida non-albicans, were C.glabrata (7.5%). Also, it was observed that in 56.6% of the cases C. albicans presented bacterial associations. The most common microbial association was C. albicans and S.aureus (26.6%), followed by C. albicans and E.coli (20.8%). Candida spp. showed moderate antifungal resistance. The resistance rate of C. albicans isolates to miconazole, fluconazole and itraconazole was 25.5%, 17.0% and 11.4% compared to non-albicans Candida strains which showed a resistance rate of 10,8%, 14.4% and 10%, respectively. Conclusions. C. albicans is the most frequently isolated species among patients with VVC, but there is also an increase share of non-albicans Candida species such as C. glabrata. C. albicans isolates showed higher indices of resistance, than Candida non-albicans.


2007 ◽  
Vol 56 (2) ◽  
pp. 255-259 ◽  
Author(s):  
Eiman M. Mokaddas ◽  
Noura A. Al-Sweih ◽  
Zia U. Khan

Bloodstream infections due to Candida species are important complications in severely ill hospitalized patients. This study presents data on species distribution and antifungal susceptibility profiles of Candida bloodstream isolates obtained from Kuwait during a 10-year period. All the bloodstream isolates were identified to species level by the germ tube test and carbohydrate assimilation profile using the VITEK 2 yeast identification system. Using E-test strips for amphotericin B, fluconazole, 5-flucytosine and voriconazole, MICs were determined on RPMI agar supplemented with 2 % glucose. The MIC breakpoints for resistance were based on Clinical and Laboratory Standards Institute criteria or those published by reference laboratories, and were as follows: amphotericin B, >1 μg ml−1; fluconazole, ⩾64 μg ml−1; 5-flucytosine, ⩾32 μg ml−1; and voriconazole, 4 μg ml−1. In all, 607 bloodstream yeast isolates were obtained over the past 10 years in Kuwait. Candida albicans was the predominant species (39.5 %), followed by Candida parapsilosis (30.6 %), Candida tropicalis (12.4 %), Candida glabrata (5.6 %) and Candida krusei (1.6 %). All C. albicans, C. tropicalis and C. glabrata isolates were susceptible to amphotericin B. Of 186 isolates of C. parapsilosis tested, only four (2 %) exhibited an MIC for amphotericin B of >1 μg ml−1. Resistance to fluconazole was observed in nine (3.8 %) C. albicans isolates, two (5.8 %) C. glabrata isolates and four (40 %) C. krusei isolates. Resistance to 5-flucytosine was observed in two (0.8 %) C. albicans isolates, seven (9.3 %) C. tropicalis isolates, three (1.6 %) C. parapsilosis isolates and all ten (100 %) C. krusei isolates. All the isolates of C. albicans, C. tropicalis, C. parapsilosis, C. glabrata and C. krusei were susceptible to voriconazole, including those resistant to fluconazole. Although amphotericin B and fluconazole are widely used in clinical practice in Kuwait, resistance to these drugs remained low.


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