scholarly journals Antifungal susceptibility pattern of Candida spp. isolated from vaginal discharge of pregnant women

2020 ◽  
Vol 28 (1) ◽  
Keyword(s):  
Pregnant Women ◽  
Vaginal Discharge ◽  
Antifungal Susceptibility ◽  
Vaginal Candidiasis ◽  
Diffusion Method ◽  
Susceptibility Pattern ◽  
Candida Spp ◽  
Factors Associated ◽  
Vaginal Swabs ◽  
Risks Factors

Vaginal candidiasis is common fungal infections among pregnant women. The aim of this study is to determine antifungal susceptibility pattern of Candida spp. isolated from vaginal discharge and to investigate possible risk factors associated with Candida infection. One hundred high vaginal swabs were collected from pregnant women complaining from abnormal discharge from various clinics in Gaza city, during 2019. Samples were plated on Sabouraud Dextrose Agar supplemented with chloramphenicol. Candida isolates were identified to the Genus level based on cultural and morphological characteristic. The susceptibility to seven antifungals was determined using disc diffusion method. Demographic, environmental, behavioral and other possible risks factors associated with vaginal candidiasis were recorded through an interview with patients before collecting the vaginal swabs and after obtaining a verbal consent. Data analysis was done using the SPSS software. Candida spp. was isolated from 43% of vaginal swabs of pregnant women with discharge. Variations existed in the susceptibilities of the different Candida isolates to antifungals. Amphotericin B the most effective with 0% resistance followed by itraconzaol and nystatin with 9.4% resistance. Resistance to miconazole, ketoconazole, voriconazole and fluconazole was 11.6%. Statistically significant symptoms associated with positive Candida spp. cultures among pregnant women included; redness of vaginal area, secretions, yeast-like smell, urinary urgency, low sexual desire, itching and irritation (p ≤ 0.05). No statistical significance difference with regard to burning urinary sensation and painful intercourse. Candida spp. was isolated from 43% of vaginal swabs from pregnant women. Risks factors should be minimized by patient education and routine testing of pregnant women.

scholarly journals Speciation Of Candida Isolated From Cases Of Vaginal Candidiasis

2021 ◽  
Vol 2 (1) ◽  
pp. 5-13
Author(s):  
Ankita Guragain ◽  
Ramesh Bichchha
Keyword(s):  
Candida Species ◽  
Reproductive Tract ◽  
Antifungal Susceptibility ◽  
Microscopic Analysis ◽  
Female Reproductive Tract ◽  
Vaginal Candidiasis ◽  
Diffusion Method ◽  
Candida Spp ◽  
Disk Diffusion Method ◽  
Vaginal Swabs

Background: Vulvovaginal Candidiasis (VVC) is an exceedingly common mucosal infection of the lower female reproductive tract. Mostly, it is caused by Candida albicans. Yet, non-albicans Candida species are also on the rise. Also, increasing resistance to commonly prescribed antifungal agents is of serious concern. Methodology: High vaginal swabs were collected from clinically suspected cases of VVC from patients attending outpatient department of Obstetrics and Gynecology of NMCTH. The swabs were subjected to microscopic analysis and culture. Germ tube test, CHROMagar, chlyamydospore formation test and sugar assimilation test were applied for identification of the isolated Candida spp. Antifungal susceptibility testing of the isolates to fluconazole was done by disk-diffusion method. Results: The rate of culture positive cases of VVC was 46.3%. Most number of cases belonged to the age group of 18-27 years (43.6%). Adhibasi-janajati and married women were most commonly affected (55.9% and 62.3% respectively). Abnormal vaginal discharge with burning and itching were the most common symptoms. C. albicans accounted for the majority of the isolated Candida spp. (57.8%), followed by C. glabrata (26.5%) and C. tropicalis (9.8%), C. krusei (3.0%), C. parapsilosis (2.0%) and C. keyfr (0.9%). A total of 34.3% of isolated Candida spp. were resistant to fluconazole. Conclusion: Both C. albicans and non-albicans Candida species were responsible for acute cases of VVC and RVVC. A majority of nonalbicans Candida species were found to be resistant suggesting rise in their prevalence and resistance to fluconazole.

scholarly journals Prevalence and Antifungal Susceptibility of Candida albicans Causing Vaginal discharge Among Pregnant Women in Lebanon

2019 ◽  
Author(s):  
Nahed Ghaddar ◽  
Elie Anastasiadis ◽  
Rawad Halimeh ◽  
Ali Ghaddar ◽  
Rita Dhar ◽  
...  
Keyword(s):  
Candida Albicans ◽  
Pregnant Women ◽  
Candida Species ◽  
Vaginal Discharge ◽  
Antifungal Susceptibility ◽  
Test Method ◽  
Neonatal Outcomes ◽  
Vaginal Candidiasis ◽  
Adverse Neonatal Outcomes ◽  
Susceptibility Tests

Abstract Background: Vaginal candidiasis is frequently prevalent in pregnant women and is associated with sepsis and adverse neonatal outcomes. This study determined the presence of Candida species in symptomatic pregnant women and evaluated the antifungal susceptibility profile of the isolated strains. It also aimed to explore whether Candida species predicts gestational complications and adverse neonatal outcomes. Methods: A total of 258 pregnant women at 35 to 37 week of gestation participated in this study. Vaginal swabs from these patients were collected at various obstetrics and gynecology clinics in Lebanon for a period of 12 months. Candida isolates were identified at species level and antifungal susceptibility of Candida albicans to fluconazole (FCZ), amphotericin B (AMB), itraconazole (ICZ) and voriconazole (VCZ) was determined by the agar-based E-test method. Results: Among 258 women tested, 100 (39%) were positive for Candida species. C. albicans, C. glabrata and C. krusei were isolated from 42%, 41% and 17% of the women, respectively. C. albicans had significant positive associations with gestational diabetes while C. kreusi or C. glabrata had significant positive associations with gestational complications and vaginal discharge. The antifungal susceptibility tests of C. albicans isolates revealed 97.5%, 90%, 87.5% and 97.5% susceptibility to AMB, FCZ, ICZ and VCZ, respectively. Conclusion: The current study revealed high incidence of both C. albicans and non-C. albicans strains causing vulvovaginitis among pregnant women in Beirut, Lebanon. Whereas the susceptibility rates of C. albicans against AMB and VCZ were high, FCZ and ICZ proved comparatively less efficacious. The resistance profile of circulating C. albicans among pregnant women can predict the best outcome of appropriate prophylaxis or treatment of neonatal candidiasis. Vaginal candida colonization might lead to adverse neonatal outcome or gestational complications thus Candida screening as antennal follow up is advised.

scholarly journals Prevalence and Antifungal Susceptibility of Candida albicans Causing Vaginal discharge Among Pregnant Women in Lebanon

2019 ◽  
Author(s):  
Nahed Ghaddar ◽  
Elie Anastasiadis ◽  
Rawad Halimeh ◽  
Ali Ghaddar ◽  
Rita Dhar ◽  
...  
Keyword(s):  
Candida Albicans ◽  
Pregnant Women ◽  
Candida Species ◽  
Vaginal Discharge ◽  
Antifungal Susceptibility ◽  
Test Method ◽  
Neonatal Outcomes ◽  
Vaginal Candidiasis ◽  
Adverse Neonatal Outcomes ◽  
Susceptibility Tests

Abstract Background: Vaginal candidiasis is frequently prevalent in pregnant women and is associated with sepsis and adverse neonatal outcomes. This study determined the presence of Candida species in symptomatic pregnant women and evaluated the antifungal susceptibility profile of the isolated strains. It also aimed to explore whether Candida species predicts gestational complications and adverse neonatal outcomes. Methods: A total of 258 pregnant women at 35 to 37 week of gestation participated in this study. Vaginal swabs from these patients were collected at various obstetrics and gynecology clinics in Lebanon for a period of 12 months. Candida isolates were identified at species level and antifungal susceptibility of Candida albicans to fluconazole (FCZ), amphotericin B (AMB), itraconazole (ICZ) and voriconazole (VCZ) was determined by the agar-based E-test method. Results: Among 258 women tested, 100 (39%) were positive for Candida species. C. albicans, C. glabrata and C. krusei were isolated from 42%, 41% and 17% of the women, respectively. C. albicans had significant positive associations with gestational diabetes while C. kreusi or C. glabrata had significant positive associations with gestational complications and vaginal discharge. The antifungal susceptibility tests of C. albicans isolates revealed 97.5%, 90%, 87.5% and 97.5% susceptibility to AMB, FCZ, ICZ and VCZ, respectively. . Conclusion: The current study revealed high incidence of both C. albicans and non-C. albicans strains causing vulvovaginitis among pregnant women in Beirut, Lebanon. Whereas the susceptibility rates of C. albicans against AMB and VCZ were high, FCZ and ICZ proved comparatively less efficacious. The resistance profile of circulating C. albicans among pregnant women can predict the best outcome of appropriate prophylaxis or treatment of neonatal candidiasis. Vaginal candida colonization might lead to adverse neonatal outcome or gestational complications thus Candida screening as antennal follow up is advised.

scholarly journals Prevalence and Antifungal Susceptibility patterns of Candida isolated on CHROMagarTMCandida at a tertiary referral hospital, Eastern Uganda.

2019 ◽  
Author(s):  
Juliet Watsemwa ◽  
Jacob Iramiot ◽  
JOHN BOSCO KALULE
Keyword(s):  
Pregnant Women ◽  
Amphotericin B ◽  
Vaginal Discharge ◽  
Antifungal Susceptibility ◽  
Vulvovaginal Candidiasis ◽  
Referral Hospital ◽  
Vaginal Candidiasis ◽  
Dilution Method ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital

Abstract Background Pregnant women are susceptible to vaginal candidiasis and maternal vulvovaginal candidiasis is a major risk factor for colonization and/or infection of the infant. The purpose of this study was to determine the prevalence and antifungal patterns of albicans and non-albicans Candida among pregnant women attending a tertiary referral hospital. Methods Vaginal discharge- cotton swabs were self-collected from pregnant women clinically proven to have vulvovaginal candidiasis at the antenatal clinic of a tertiary referral hospital between January and July 2018. Microscopy and culture on Sabouraud's Dextrose Agar with chloramphenicol was done on the vaginal discharge-cotton swabs. Confirmatory fungal identification was done using CHROM agarTM Candida. Antifungal susceptibility testing was carried out using the standardized Kirby Bauer dilution method. Results Candida were isolated from 50.81% (126/249) of the swabs and included C. albicans (80.16%, 101/126), C. glabrata (19.05% (24/126) and C. krusei (0.79%, 1/126). Of the women from whom Candida were isolated, 11.1% (14/126) were in the first trimester, 39.7% (50/126) were in the second, while 49.2% (62/126) were in the third. Of the Candida isolates, 80.16% (101/126) were C. albicans, 19.05% (24/126) were C. glabrata and 0.79% (1/126) were C. krusei. Overall, all the isolates were non-susceptible to Amphotericin B, while 60.3% (76/126), 50% (63/126), 62.7% (79/126), and 48.4% (61/126) were non-susceptible to itraconazole, fluconazole, nystatin, and clotrimazole respectively. All the non-albicans Candida were resistant to itraconazole, amphotericin B, and fluconazole. Conclusion Vulvovaginal candidiasis due to multidrug resistant C.glabrata among pregnant women will require that treatment regimes are adjusted to carter for the recurrent forms. The use of CHROMagarTMCandida media for identification of clinically relevant Candida should be adopted instead of conventional methods that are tedious and time consuming such that treatment is based on laboratory evidence.

scholarly journals Antifungal Susceptibility Pattern of Candida Isolates Causing Vulvovaginitis in Reproductive Age Women

2020 ◽  
Vol 7 ◽  
pp. 1-7
Author(s):  
Pabitra Shrestha ◽  
Sunil Mani Pokharel ◽  
Anima Shrestha
Keyword(s):  
Candida Species ◽  
Clinical Laboratory ◽  
Antifungal Susceptibility ◽  
Vaginal Swab ◽  
Tube Formation ◽  
Reproductive Age ◽  
Vaginal Candidiasis ◽  
Susceptibility Pattern ◽  
Candida Spp ◽  
Lactose Fermentation

Objectives: The study was designed to isolate and identify Candida species from high vaginal swab, and to determine the antifungal susceptibility pattern of Candida spp. among women of reproductive age group i.e. 15- 50 years old. Methods: High vaginal swabs were processed to isolate Candida species and identified by Gram’s stain, germ tube formation test, carbohydrate (glucose, sucrose, maltose, lactose) fermentation tests and antifungal susceptibility test were performed as recommended by Clinical Laboratory Standard Institute. Results: Out of total 261 samples, 42.1% (110/261) were found to be culture positive for Candida spp. Candida albicans was the most common (56.4%) and among non-albicans, predominate species was C. krusei (19.1%) isolated from high vaginal swab specimens All the isolates of Candida species were sensitive to Nystatin and Miconazole and resistant to Itraconazole. Fluconazole, Itraconazole and Clotrimazole are widely used drug against vaginal candidiasis but showed high resistance which leads to treatment failure. Conclusion: This study on the infection rate of Candida and its antifungal susceptibility pattern may help in the choice of appropriate therapy in the clinical setting.

scholarly journals Prevalence, species distribution and antifungal susceptibility of Candida albicans causing vaginal discharge among symptomatic non-pregnant women of reproductive age at a tertiary care hospital, Vietnam

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Do Ngoc Anh ◽  
Dao Nguyen Hung ◽  
Tran Viet Tien ◽  
Vu Nhat Dinh ◽  
Vu Tung Son ◽  
...  
Keyword(s):  
Candida Albicans ◽  
Pregnant Women ◽  
Species Distribution ◽  
Vaginal Discharge ◽  
Antifungal Agents ◽  
Antifungal Susceptibility ◽  
Reproductive Age ◽  
Vaginal Candidiasis ◽  
Care Hospital ◽  
Women Of Reproductive Age

Abstract Background Vaginal candidiasis is frequent in women of reproductive age. Accurate identification Candida provides helpful information for successful therapy and epidemiology study; however, there are very limited data from the Vietnam have been reported. This study was performed to determine the prevalence, species distribution of yeast causing vaginal discharge and antifungal susceptibility patterns of Candida albicans among symptomatic non-pregnant women of reproductive age. Methods Vaginal discharge samples were collected from 462 women of reproductive age in Hanoi, Vietnam between Sep 2019 and Oct 2020. Vaginal swabs from these patients were examined by direct microscopic examination (10% KOH). CHROMagar™ Candida medium and Sabouraud dextrose agar supplemented with chloramphenicol (0.5 g/l) were used to isolate yeast, and species identification was performed using morphological tests and molecular tools (PCR and sequencing). Antifungal susceptibility testing was determined according to the Clinical and Laboratory Standards Institute guidelines (M27-A3 and M27-S4). Results The prevalence of vaginal yeast colonization in non-pregnant women was 51.3% of 462 participants. Nine different yeast species were identified. Among these isolates, C. albicans (51.37%) was the most frequent, followed by C. parapsilosis (25.88%), C. glabrata (11.37%), C. tropicalis (4.31%), C. krusei (3.92%), C. africana (1.57%), Saccharomyces cerevisiae (0.78%), C. nivariensis (1 isolates, 0.39%), and C. lusitaniae (1 isolates, 0.39%), respectively. Among C. albicans, all 46 isolates were 100% susceptible to micafungin, caspofungin, and miconazole. The susceptibility rates to amphotericine B, 5-flucytosine, fluconazole, itraconazole and voriconazole were 95.65, 91.30, 91.30, 82.61 and 86.95%, respectively. Conclusions The prevalence of VVC among symptomatic non-pregnant women of reproductive age in Vietnam was higher than many parts of the world. The high frequency of non-albicans Candida species, which were often more resistant to antifungal agents, was a notable feature. Resistance rates of vaginal C. albicans isolates to antifungal agents was low. Our findings suggest that continued surveillance of changes in species distribution and susceptibility to antifungals should be routinely screened and treated.

scholarly journals Antifungal Susceptibility and Biofilm Production of Candida spp. Isolated from Clinical Samples

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Munmun B. Marak ◽  
Biranthabail Dhanashree
Keyword(s):  
Antifungal Susceptibility ◽  
Clinical Information ◽  
Antibiotic Use ◽  
Microtiter Plate ◽  
Vaginal Swab ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Candida Spp ◽  
Disk Diffusion Method ◽  
Biofilm Production

Objective. The study aims to speciate clinical Candida isolates and detect their biofilm-forming ability and antifungal resistance. Methods. All the Candida spp. isolated from different clinical samples like pus, urine, blood, and body fluid were included in the study. Biofilm production was tested by the microtiter plate method. Antifungal susceptibility was studied by the disk diffusion method. Patient’s demographic details such as age, sex, and clinical information were collected. Presence of other risk factors such as diabetes mellitus, history of antibiotic use, and any urinary tract instrumentations was also recorded. Results. Among 90 Candida species isolated, most predominant species was found to be C. albicans (45.5%) followed by C. tropicalis (28.88%), C. krusei (20%), C. glabrata (3.33%), and C. parapsilosis (2.22%). Candida spp. were isolated from urine (43%), BAL/sputum (18.88%), high vaginal swab (8.88%), suction tips (7.77%), blood and wound swabs (6.66%), pus (3.33%), bile aspirate (2.22%), and deep tissue (1.11%). A larger number of females were affected than males, and the age group of 51 to 60 years was more susceptible to candidiasis. A higher number of C. albicans isolates produced biofilm followed by C. parapsilosis, C. tropicalis, and C. krusei. However, C. glabrata showed no biofilm production in our study. All Candida isolates were 100% sensitive to amphotericin B. Voriconazole was the next effective drug with 81.11% susceptibility. 24.44% of strains were resistant to fluconazole. Conclusion. Speciation of Candida isolates, detection of ability to form the biofilm, and monitoring of antifungal susceptibility testing are necessary for appropriate treatment.

HIGH VAGINAL SWABS;

2017 ◽  
Vol 24 (04) ◽  
pp. 622-626
Author(s):  
Shamas Pervaiz ◽  
Faiza Sarwar ◽  
Abdul Rauf ◽  
Muhammad Saifullah
Keyword(s):  
Pathogenic Bacteria ◽  
Vaginal Discharge ◽  
Care Center ◽  
Diffusion Method ◽  
Sensitivity Testing ◽  
Gram Negative ◽  
Health Care Center ◽  
Sensitivity Pattern ◽  
Wide Range ◽  
Vaginal Swabs

Normal vaginal flora contains a wide range of microorganisms. Hydrogen peroxideproduced by Lactobacillus strains plays a vital role in maintaining the microenvironment of thevagina and in the inhibition of overgrowth of potentially pathogenic bacteria. Bacterial vaginosisBV is the main reason of vaginal discharge. Many gram positive and gram negative rods i.e.E.coli, Klebsiella, Proteus, Acinetobacter and Pseudomonas spp. are major contributors inbacterial vaginosis. Aim: The present study was conducted to elucidate the frequency of variousgram-negative rods in high vaginal swabs and sensitivity pattern of bacteria to antibiotics thatare currently used. Study Design: Cross sectional study. Setting: Department of Obstetricsand Gynecology of Benazir Bhutto Hospital Rawalpindi, a tertiary health care center for thepeople of Rawalpindi. Period: January 2015 to May 2016. Material and Methods: A total of220 High vaginal swabs (HVS) were collected both from indoor and outdoor patients presentingwith symptoms of vaginal discharge aged between 20 to 65 years. Swabs were inoculated onblood, Chocolate and MacConkey’s agar. After overnight incubation plates were examined forgrowth, colonial morphology, final confirmation was done on the basis of biochemical testingand API 20-E system (BioMerieux, France) up to species level. Antibiotic sensitivity testing wasdone by (modified Kirby-Bauer’s) disc diffusion method using amikacin, ampicillin, amoxicillinclavulanic acid, imipenem, ceftazidime, tigecycline, ciprofloxacin, sulzone and cefixime. Afterovernight incubation plates were examined to read the susceptibility zone. Results: Out of 220HVS samples, 100 samples showed bacterial growth and confirmed as Gram negative bacilli.Age wise distribution of infection showed highest rates b/w age 20-30 was 36% followed by 31-40 (23%), 41-50 (25%) and 11% above 50 years of age. Bacteria isolated from HVS were E.coli(53%), Klebsiella (22%), Pseudomonas (12%), citrobacter (6%), Proteus (5%) and Acinetobacter(2%) respectively. Highly sensitive antibiotics against bacteria were imipenem (96%), sulzone(90%) and Ciprofloxacin (88%), whereas least affective antibiotics against gram negative rodswere penicillins (ampicillin, amoxicillin-clavulanic acid), amikacin due to indiscriminate use ofantibiotics. Conclusion: High prevalence of gynecological infections demands that the patientswho have vaginosis must be investigated regularly and carefully through culture and identificationof causative bacteria. Emergence of antibiotic resistance must be controlled in order to avoidimproper use, frequent abuse, insufficient dosages, trouble-free availability of antibiotics andtreatment schedule must be designed subsequent to proper laboratory investigations.

scholarly journals Antimicrobial resistance among fungi from patients with urinary tract infections in Ojo, Lagos, Nigeria

2021 ◽  
Vol 14 (03) ◽  
pp. 254-264
Author(s):  
Dauphin Dighitoghi Moro ◽  
Oluwole Moses David
Keyword(s):  
Urinary Tract ◽  
Amphotericin B ◽  
Urinary Tract Infections ◽  
Fungal Pathogens ◽  
Fungal Infections ◽  
Antifungal Susceptibility ◽  
Candida Spp ◽  
Fungal Isolates ◽  
Vaginal Swabs ◽  
Tract Infections

The incidence of fungal urinary tract infections has risen gradually and has thus constituted a public health challenge. The aim of this study was to determine the prevalence of urinary tract infections by fungi in two health centres in Ojo, Lagos. A total of 200 patients attending the health centers constituting 160 males’ urines and 40 females’ vaginal swabs were recruited for this study. Midstream urine samples and vaginal swabs were aseptically collected and processed using standard mycological techniques. Fungal isolates were identified based on cultural characteristics, lactophenol blue stain, chlamydospore formation, colony colour on CHROM agar Candida medium and API yeast identification. Antifungal susceptibility testing of the isolates was performed by using the Broth dilution and Kirby-Bauer disk diffusion methods using two of the most commonly used antifungal agents. A total of 122 fungal isolates, of which 68 (55.7%) were Candida spp. and 54(44.3%) Aspergillus spp. were recovered. The Candida spp. included 64 (52.5%) C. albicans and 4(3.3%) C. glabrata while Aspergillus spp. included A. flavus, 20(16.4%), A. fumigatus, 24 (19.8%) and A niger, 10(8.2%). The most common fungal pathogens in the urinary tracts of the subjects were Candida albicans and Aspergillus fumigatus. Both C. albicans and A. fumigatus were highly susceptible to both fluconazole and amphotericin B in dimethyl sulphoxide and water (90-100%). Similarly, all Aspergillus spp. were susceptible to both antifungals except A. flavus which showed a slight resistance (10-15%), which appears to be emerging. Both fluconazole and amphotericin B still show high chances of therapeutic efficacy against fungal infections of the urinary tracts.

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