Species distribution and susceptibility profiles of Candida species isolated from vulvovaginal candidiasis, emergence of C. lusitaniae

Background and Purpose: The aim of the current study was to investigate the epidemiology of vulvovaginal candidiasis (VVC) and recurrent VVC (RVVC), as well as the antifungal susceptibility patterns of Candida species isolates.Materials and Methods: A cross-sectional study was carried out on 260 women suspected of VVC from February 2017 to January 2018. In order to identify Candida species isolated from the genital tracts, the isolates were subjected to polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) using enzymes Msp I and sequencing. Moreover, antifungal susceptibility testing was performed according to the Clinical and Laboratory Standards Institute guidelines (M27-A3).Results: Out of 250 subjects, 75 (28.8%) patients were affected by VVC, out of whom 15 (20%) cases had RVVC. Among the Candida species, C. albicans was the most common species (42/95; 44.21%), followed by C. lusitaniae (18/95; 18.95%), C. parapsilosis (13/95; 13.69%), C. glabrata (8/95; 8.42%), C. kefyr (6/95; 6.31%), C. famata (5/95; 5.26%), C. africana (2/95; 2.11%), and C. orthopsilosis (1/95; 1.05%), respectively. Multiple Candida species were observed in 28% (21/75) of the patients. Nystatin showed the narrowest range of minimum inhibitory concentration (MIC) (0.25-16 μg/ml) against all Candida strains, whereas fluconazole (0.063-64 μg/ml) demonstrated the widest MIC range. In the current study, C. lusitaniae, as the second most common causative agent of VVC, was susceptible to all antifungal agents. Furthermore, 61.1% of C. lusitaniae isolates were inhibited at a concentration of ≤ 2 μg/ml, while38.9% (n=7)of them exhibited fluconazole MICs above the epidemiologic cutoff values (ECV). Candida species showed the highest overall resistance against fluconazole (61.3%), followed by itraconazole (45.2%) and caspofungin (23.7%). All of C. albicans strains were resistant to itraconazole with a MIC value of ≥ 1 μg/ml; in addition, 87.5% of them were resistant to fluconazole. Moreover, 100% and 87.5% of C. glabrata strains were resistant to caspofungin and fluconazole, respectively.Conclusion: As the findings revealed, the majority of VVC cases were caused by non-albicans Candida species which were often more resistant to antifungal agents. Candida lusitaniae generally had fluconazole MICs above the ECV. Given the propensity of C. lusitaniae to develop resistance under drug pressure, antifungals should be administered with caution. The emergence of these species justify the epidemiological surveillance surveys to watch out the distribution of yeast species.

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Identification of various Candida species isolated from patients with vulvovaginal candidiasis attending a tertiary care hospital in North India

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20200076 ◽

2020 ◽

Vol 7 (2) ◽

pp. 261

Author(s):

Noor Jahan ◽

Pratishtha Vishnoi ◽

Bhavana Gupta ◽

Swati Srivastava ◽

Siraj Ahmad ◽

...

Keyword(s):

Candida Species ◽

Tertiary Care ◽

Common Species ◽

Cross Sectional Study ◽

Vulvovaginal Candidiasis ◽

North India ◽

Care Hospital ◽

Agar Culture ◽

Cross Sectional ◽

Candida Lusitaniae

Background: Vulvovaginal Candidiasis (VVC) is a condition diagnosed in a large proportion of women presenting with complaints of abnormal vaginal discharge. The risk of VVC is high in women with diabetes mellitus, pregnancy, using oral contraceptives or broad-spectrum antibiotics and those having Human Immunodeficiency Virus infection.Objective of the present study was to identify the various species of Candida isolated from patients with Vulvovaginal Candidiasis.Methods: A cross-sectional study was done from January to June 2018. A total of 69 clinically suspected VVC cases were included in the study whose high vaginal swabs were collected and subjected to direct microscopy and cultured on Sabouraud Dextrose Agar (SDA). Creamy white pigmented colonies on SDA were confirmed as Candida by doing Gram’s staining. Speciation of positive cultures was confirmed by conventional methods like Corn Meal agar culture, Germ tube test (GTT), Candida CHROM Agar Medium (CAM), sugar assimilation and fermentation test.Results: Out of 69 clinically suspected VVC cases included in the study, only 14 cultures were positive for Candida species. All the 14 isolates were found to be Non-albicans Candida (NAC). Most common species isolated were Candida glabrata 7(50%), followed by Candida tropicalis 3(21.4%), Candida lusitaniae 3(21.4%), and Candida parapsilosis 1 (7.1%).Conclusions: Candida albicans was known to be the most common causative agent of VVC as it was isolated in 90% cases. However, this study showed that all isolates from VVC were Non-albicans Candida. Therefore, species identification should be done in all microbiology laboratories for accurate diagnosis of VVC.

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Value of antifungal susceptibility testing in recurrent vulvovaginal Candidiasis by Non -Albicans Candida

10.51429/ejmm30120 ◽

2021 ◽

Vol 30 (1) ◽

pp. 161-167

Author(s):

Ghada A. Mokhtar ◽

Mohamed Sh. Ramadan ◽

Shymaa Yahia

Keyword(s):

Amphotericin B ◽

Candida Species ◽

Antifungal Susceptibility ◽

High Sensitivity ◽

Common Species ◽

Vulvovaginal Candidiasis ◽

Recurrent Vulvovaginal Candidiasis ◽

Sensitivity Pattern ◽

Vaginal Swabs ◽

Vitek 2

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.

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THE PREVALENCE OF VULVOVAGINAL CANDIDIASIS IN PREGNANT WOMEN ATTENDING SEVERAL HOSPITALS IN SANA’A, YEMEN

Universal Journal of Pharmaceutical Research ◽

10.22270/ujpr.v4i6.338 ◽

2020 ◽

Author(s):

Abdulrahman Humaid ◽

Saeed M Alghalibi ◽

Anes Al-Mahbashi ◽

Aml AL-Arossi ◽

Wadhah Hassan Edrees

Keyword(s):

Pregnant Women ◽

Peer Review ◽

Candida Species ◽

Antifungal Susceptibility ◽

Common Species ◽

Vulvovaginal Candidiasis ◽

University Hospital ◽

Vaginal Candidiasis ◽

Microbiological Methods ◽

E Mail

Candida species are opportunistic yeasts affecting the genitourinary tract which causes the vulvovaginal candidiasis in the most female especially in developing countries. This study aims to determine the prevalence of vulvovaginal candidiasis caused by Candida species causing among pregnant women in Sana'a City, Yemen. This study was carried out at the department of microbiology of AL-Kuwait University Hospital. 250 vaginal swabs were collected and cultured on Sabouraud dextrose agar. Candida species identification and antifungal susceptibility testing were determined according to standard microbiological methods. The results showed that out of 250 samples, 63(25.2%) were positive for Candida species. It was found that the C. albicans (68.3%) was the most common species isolated followed by non-albicans species that are C. tropicalis (20.6%), C. glabrata (6.3%), and C. kefyr (4.8%). Also, it was recorded that the highest prevalence of Candida species was within group aged of 36-46 year. Susceptibility tests revealed that the most isolated species of C. andida were sensitive to nystatin (95%). miconazole was the next effective drug with 64% sensitive followed by amphotericin B (29%) and clotrimazole (24%). But only 6% of the isolates were sensitive to fluconazole. It can be concluded that the vulvovaginal candidiasis are quite common in Yemen country with a high prevalence. Also, the nystatin remains the effective agent against all isolated of Candida species. In contrast, the increase resistance of Candida species to fluconazole that commonly used antifungal is an alarming increase of vaginal candidiasis caused by antifungal-resistant Candida species. Peer Review History: UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file Average Peer review marks at initial stage: 5.0/10 Average Peer review marks at publication stage: 8.0/10 Reviewer(s) detail: Name: Dr. Hassan A.H. Al-Shamahy Affiliation: Sana'a University, Yemen E-mail: [email protected] Name: Dr. Tamer Mohamed Ali El Habibi Affiliation: Suez Canal University, Egypt. E-mail: [email protected] Name: Rola Jadallah Affiliation: Arab American University, Palestine E-mail: [email protected] Comments of reviewer(s): Similar Articles: AN EXHAUSTIVE STATISTIC ON CURRENT MUCOADHESIVE INTRAVAGINAL DRUG DELIVERY METHODOLOGIES TETANUS IMMUNIZATION AMONG PREGNANT WOMEN: COVERAGE RATE AND RATE OF PROTECTION AT TIME OF DELIVERY

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Types of yeasts that cause vulvovaginal candidiasis in chronic users of corticosteroids

Medical Mycology ◽

10.1093/mmy/myy117 ◽

2018 ◽

Vol 57 (6) ◽

pp. 681-687 ◽

Cited By ~ 5

Author(s):

Mohammed A Farhan ◽

Ahmed M Moharram ◽

Tareq Salah ◽

Omar M Shaaban

Keyword(s):

Antifungal Agents ◽

Cross Sectional Study ◽

Vulvovaginal Candidiasis ◽

Control Group ◽

Sectional Study ◽

Cross Sectional ◽

Significant Difference ◽

Glucose Agar ◽

Chronic Corticosteroid ◽

Health Hospital

AbstractThe current study aims to compare between the types of yeasts that cause vulvovaginal candidiasis (VVC) in women using corticosteroid medication compared to nonusers and estimate their sensitivity to available commercial antifungal agents. In a descriptive analytical cross-sectional study, we recruited 41 chronic corticosteroid users diagnosed clinically to have VVC from Women's Health Hospital, Assiut University, Egypt. Forty-seven age-matched women with VVC were recruited as a control group. Full history and clinical examination were performed. Vaginal sterile swab obtained from the vagina of each participant was subjected to direct Gram-stained smear examination as well as a culture on Sabouraud's glucose agar and HiCrome Candida agar. Further identification of the isolates was done using traditional methods. Fifty out of 88 samples (56.8%) were positive in culture including 25 samples (61%) from corticosteroid users group and 25 (53.2%) from noncorticosteroid users with no statistically significant difference (P = .302). The chronic corticosteroid users had more incidence of recurrent VVC as compared to nonusers (65.9% vs 40.4%, respectively) (P = .015). There was a significantly higher rate of non-Candida albicans (NCA) infections in corticosteroid users compared with nonusers (48% vs 20%, respectively) (P = .036). A higher significant difference in resistance of the isolates against clotrimazole (P = .003) and ketoconazole (P = .017) was demonstrated in corticosteroid users compared to nonusers. Thus, chronic corticosteroid use causes frequent attacks of VVC and increases the frequency of infection by NCA strains. Also, it increases resistance to common antifungal agents especially azole group.

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Species distribution of yeasts recovered from different clinical samples Addiss Ababa,Ethiopia

10.21203/rs.2.9212/v2 ◽

2019 ◽

Author(s):

Elias Seyoum Deribe ◽

Adane Bitew ◽

Amete Mihret

Keyword(s):

Species Distribution ◽

Candida Species ◽

Fungal Infections ◽

Addis Ababa ◽

Antifungal Susceptibility ◽

Signs And Symptoms ◽

Cross Sectional Study ◽

Clinical Samples ◽

Cross Sectional ◽

Reported Data

Abstract Background Currently, fungal diseases of humans are among the most problematic illnesses is the result of an increase in opportunistic fungal infections caused by rise in the number of immune-compromised patients. Particularly, yeasts are the most common cause of fungal infections leading to a range superficial type to life-threatening invasive infections. The aim of this study is to determine species distribution of yeasts particularly of Candida species recovered from different clinical samples. Method A cross sectional study was conducted from January 01, 2018 –September 30, 2018 in Addis Ababa, Arsho laboratory. Oropharengial swabs, nail scrapings, sputum, corneal scrapings, and vaginal swabs were collected from patients with signs and symptoms of infections. Identification and antifungal susceptibility testing was performed by using YST card through VITEK 2 compact system. Data was entered and analyzed using SPSS version 20. Result A total of 209 yeasts were recovered of which 49.8% were Candida albicans, 43.1% were non-albicans candida species and 7.2% were yeasts other than Candida species. The current study, eighteen (18) different types of yeast species were identified from different clinical samples. All recognized yeast considered as a causative agent of fungal infection in previously reported data in worldwide. Conclusion C. albicans remaining the predominant species, but the emergence of non-albicans Candida and other than candida species have increased. Thus, more studies on Candida prevalence are needed throughout country.

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Species distribution of yeasts recovered from different clinical samples Addiss Ababa,Ethiopia

10.21203/rs.2.9212/v1 ◽

2019 ◽

Author(s):

Elias Seyoum Deribe ◽

Adane Bitew ◽

Amete Mihret

Keyword(s):

Species Distribution ◽

Candida Species ◽

Fungal Infections ◽

Addis Ababa ◽

Antifungal Susceptibility ◽

Signs And Symptoms ◽

Cross Sectional Study ◽

Clinical Samples ◽

Cross Sectional ◽

Reported Data

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Analysis of Сandida species distribution isolated from women with vulvovaginal candidiasis and their antifungal susceptibility profile

Health of Society ◽

10.22141/2306-2436.9.6.2020.226952 ◽

2021 ◽

Vol 9 (6) ◽

pp. 225-229

Author(s):

O.S. Burduniuc ◽

E.I. Bîrcă ◽

A.M. Burduniuc ◽

M.V. Bivol ◽

O.S. Iacon

Keyword(s):

Species Distribution ◽

Candida Species ◽

Antifungal Susceptibility ◽

Common Species ◽

Resistance Rate ◽

Vulvovaginal Candidiasis ◽

Automated System ◽

Clinical Samples ◽

Bacterial Strains ◽

Candida Spp

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.

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Distribution and Antifungal Susceptibility of Candida Species Causing Candidemia in China: An Update From the CHIF-NET Study

The Journal of Infectious Diseases ◽

10.1093/infdis/jiz573 ◽

2020 ◽

Vol 221 (Supplement_2) ◽

pp. S139-S147 ◽

Cited By ~ 4

Author(s):

Meng Xiao ◽

Sharon C-A Chen ◽

Fanrong Kong ◽

Xiu-Li Xu ◽

Li Yan ◽

...

Keyword(s):

Multidrug Resistance ◽

Candida Species ◽

Antifungal Agents ◽

Antifungal Susceptibility ◽

Common Species ◽

Sensu Stricto ◽

Resistance Rate ◽

Fluconazole Resistance ◽

Microdilution Method ◽

Broth Microdilution Method

Abstract Background Candidemia is the most common, serious fungal infection and Candida antifungal resistance is a challenge. We report recent surveillance of candidemia in China. Methods The study encompassed 77 Chinese hospitals over 3 years. Identification of Candida species was by mass spectrometry and DNA sequencing. Antifungal susceptibility was determined using the Clinical and Laboratory Standards Institute broth microdilution method. Results In total, 4010 isolates were collected from candidemia patients. Although C. albicans was the most common species, non-albicans Candida species accounted for over two-thirds of isolates, predominated C. parapsilosis complex (27.1%), C. tropicalis (18.7%), and C. glabrata complex (12.0%). Most C. albicans and C. parapsilosis complex isolates were susceptible to all antifungal agents (resistance rate <5%). However, there was a decrease in voriconazole susceptibility to C. glabrata sensu stricto over the 3 years and fluconazole resistance rate in C. tropicalis tripled. Amongst less common Candida species, over one-third of C. pelliculosa isolates were coresistant to fluconazole and 5-flucytocine, and >56% of C. haemulonii isolates were multidrug resistance. Conclusions Non-albicans Candida species are the predominant cause of candidemia in China. Azole resistance is notable amongst C. tropicalis and C. glabrata. Coresistance and multidrug resistance has emerged in less common Candida species.

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Utility of VITEK2 in Rapid Speciation and Antifungal Susceptibility Testing of Yeasts in a Resource Constrained Setting

International Journal of Health Sciences and Research ◽

10.52403/ijhsr.20211119 ◽

2021 ◽

Vol 11 (11) ◽

pp. 145-155

Author(s):

Sukanya Verma ◽

Gita Nataraj ◽

Shashir Wanjare

Keyword(s):

Conventional Method ◽

Candida Species ◽

Antifungal Agents ◽

Antifungal Susceptibility ◽

Common Species ◽

Turnaround Time ◽

Resource Constrained ◽

Time Saving ◽

Conventional Methods ◽

The Cost

Introduction- Incidence of invasive Candidiasis is on a rise. C.albicans is the most common species implicated, however recently increase in infection due to Non Albicans Candida species has also been noted. Empirical use of antifungal agents has led to emergence of resistance. The newer Non albicans Candida species are known to be inherently resistant to some of the antifungal agents. Hence it is necessary to speciate and determine the antifungal susceptibility pattern of pathogenic Candida species. The conventional methods of identification and antifungal susceptibility are labour intensive and time consuming Newer automated methods are easy to perform and help reduce the turnaround time. Aim and Objectives- This study was carried out to access the usefulness of VITEK2 in identification and AFST of yeast in a resource constrained setting with respect to TAT and cost. Materials and Method- Species identification and antifungal susceptibility profile of 100 yeast isolates recovered was determined using conventional methods and VITEK2. The results obtained by both method were analysed for Concordance, TAT and Cost Results- 95% essential agreement was observed between VITEK2 and conventional method. For fluconazole the essential agreement was found to be 96% and for amphotericin B, it was 98%. TAT by VITEK2 was significantly lower compared to conventional method. The cost per test was higher for VITEK2. Conclusion- VITEK2 is a reliable, feasible, time saving alternative for identification and antifungal susceptibility of the yeasts. Key words: Non Albicans Candida species, Antifungal resistance, VITEK2, reliable, feasible.

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Enteroparasitosis in patients attended by the health public service: epidemiology and spatial distribution

Scientia Medica ◽

10.15448/1980-6108.2020.1.34764 ◽

2020 ◽

Vol 30 (1) ◽

pp. 34764

Author(s):

Andressa Barros Ibiapina ◽

Janaína Soares Leal ◽

Pedro Ricardo Alves de Santana ◽

Marcelo Ribeiro Mesquita ◽

Tito Lívio da Cunha Lopes ◽

...

Keyword(s):

Spatial Distribution ◽

Entamoeba Histolytica ◽

Ascaris Lumbricoides ◽

Rural Areas ◽

The Elderly ◽

Common Species ◽

Cross Sectional Study ◽

Cross Sectional ◽

Intestinal Parasitosis ◽

The City

AIMS: This research aims to determine the epidemiology and the spatial distribution of intestinal parasitosis in the city of Teresina.METHODS: A cross-sectional study was carried out based on the data of parasitological fecal exams performed in the Laboratory Raul Bacelar between January, 2014 and July, 2017. In addition to the prevalence of intestinal parasitosis and polyparasitism, we verified the association of these diseases with gender, zone and period of the year by means of the chi-squared test, whereas the relation with age was analyzed by the Mann-Kendall tests and multiple comparisons of age classes. The spatial distribution was performed using the QGIS georeferencing software.RESULTS: The prevalence of enteroparasitosis in Teresina is 17,8% with Ascaris lumbricoides being the most common species, due to the precarious sanitary conditions of the city. The prevalence of individuals with polyparasitism is 3,13%, in which an association between the species Entamoeba coli and Entamoeba histolytica/dispar was found. There was no relation between intestinal parasitosis with gender, but we verified that individuals in rural areas are more susceptible to these diseases. The species Ascaris lumbricoides and Entamoeba histolytica/dispar occur more frequently in the first and second semester, respectively. We observed that there is an apparent tendency to increase cases of E. histolytica/dispar and reduction of cases of Giardia sp. according to aging. Mapping intestinal parasitosis showed us that there is a prevalence between one and 20% in most of Teresina's neighborhoods, and Ascariasis embodies at least 40% of cases of enteroparasitosis in these neighborhoods.CONCLUSIONS: Investments in basic sanitation and new epidemiological investigations must be carried out to control intestinal parasitosis in Teresina, emphasizing that children and the elderly should be considered priority groups in these programs.

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