Vulvovaginal candidiasis in Mato Grosso, Brazil: pregnancy status, causative species and drugs tests (original) (raw)
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Open Journal of Obstetrics and Gynecology, 2016
Purpose: To evaluate the profile of in vitro susceptibility of yeasts isolated from cases of primary and espisodic vulvovaginitis to two antifungal agents. Methods: 40 Candida isolates from episodes of vulvovaginal candidiasis were identified by classic methodologies. The susceptibility testing of the in vitro fluconazole and ketoconazole activity against the isolates was accessed by E-test. Results: C. albicans was the most common species identified in 70% of the occurrences followed by C. glabrata (20%), C. tropicalis (7.5%), and C. guilliermondii (2.5%). In the susceptibility profile to antifungal agents, 12.5% and 16.7% of the isolates obtained from primary and episodic vulvovaginal candidiasis were resistant to fluconazole, respectively. To ketoconazole, we found that 6.25% and 12.5% of the isolates respectively from primary vulvovaginal candidiasis (PVVC) and episodic vulvovaginal candidiasis (EVVC) had high MIC values. Conclusions: E-test is a reliable method for the susceptibility testing of Candida spp. due to its simplicity, reproducibility, and lack of specialized equipment. Resistant strains and non-albicans species were verified more in cases of EVVC than in PVVC. Clinical and mycological cure of patients with episodic vulvovaginal candidiasis or complicated cases occurred after prolonged treatment and sometimes with multiple antifungals use.
2020
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. 1550 years old. Methods: High vaginal swabs were processed to isolate Candida species and identifi ed 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 sh...
Innovative publication, 2016
Aim/Objectives: To determine the predominant candidal species in Vulvovaginal Candidiasis. To find out the antifungal susceptibility pattern of the candidal isolates and to assess the risk factor associated with Vulvo-Vaginal Candidiasis (VVC). Methods: A total of 100 high vaginal swabs (HVS) were collected from women suspected of having Candidal Vulvovaginitis from May 2014 to February 2015. Wet mount preparations in potassium hydroxide (KOH) and Gram-stained smears were performed directly on specimens. Cultures for Candida species were done using Sabouraud's dextrose agar (SDA) at room temperature (25-28ºC). Antifungal susceptibility of the Candida species to Amphotericin B, Fluconazole and Ketoconazole was assessed using the NCCLS guidelines on Mueller Hilton agar. Results: The incidence of non albicans (60%) was significantly higher than the Candida albicans (40%) which was found to be sensitive to Fluconazole (95%) followed by Amphotericin B (85%). The common presenting symptoms of vulvovaginitis found to be thick white vaginal discharge followed by itching pruritus. Conclusion: The predominant candidal species in vulvovaginitis was non-albicans (candida tropicalis). Candida was most sensitive to fluconazole.
DETERMINATION OF VULVOVAGINAL CANDIDIASIS IN TERTIARY CARE HOSPITAL
Asian Journal of Pharmaceutical and Clinical Research Journal, 2022
Objectives: Infections of vulva and vagina are commonly encountered in gynecology practice. These infections are predominant in the women of reproductive age group so, this study was done to determine the prevalence of vaginal candidiasis and identify, differentiate Candida species isolated from the patients. Three high vaginal swabs per patients were collected using sterile cotton-tipped swabs from Gynecology Department and processed in Department of Microbiology, MLBMC, India. Candida was identified using standard guidelines. The study was done on 350 women in reproductive age group (18-49 years), 63.4% were non-pregnant and 36.5% pregnant. One hundred and sixteen/350 (33.1%) samples showed pure growth of Candida species. Candida positivity among pregnant women (42.9%) was higher than in non-pregnant women (27.1%). Isolation of non-albican Candida was higher (26.7%) than Candida albicans, this difference was statistically significant (p<0.05) The most common isolated species by conventional methods was C. albicans (36.3%) followed by Candida glabrata (24.1%), Candida tropicalis (22.5%), Candida krusei (10.3), and Candida parapsilosis (7.7%). In case of C. albicans, Fluconazole and Amphotericin B were found to be most sensitive drugs followed by Nystatin, voriconazole and ketoconazole and among non-albicans candida, Nystatin was the highly sensitive drug. Vulvovaginal candidiasis (VCC) is the most common infection in the women reproductive age group. Several predisposing factors such as HIV, diabetes mellitus, oral contraceptive, IUCD usage, antibiotics, and immunosuppressive drug increase the VCC, C. albicans was the most prevalent species followed by C. glabrata and C. tropicalis.
Infection and Drug Resistance, 2018
Background: Vulvovaginal candidiasis (VVC) is considered as a pervasive gynecological problem among women worldwide. Owing to this fact, in the current study, we aimed at assessing the prevalence rate of Candida spp. causing VVC in symptomatic pregnant women and their antifungal susceptibility pattern. Methods: This study was carried out in the tertiary care hospitals of Peshawar during the period of July 1, 2016 to December 31, 2016. The study group included 450 pregnant women in the age group of 17-44 years with symptoms of excessive vaginal discharge, pain and pruritis. In all, 108 pregnant women were culture positive for Candida. Antimicrobial susceptibility testing (AST) was conducted on specimens against various azoles and polyene F group of antifungals. Results: Out of 108 Candida spp. isolated from vaginal swabs, there were 45 (41.7%) Candida albicans, 18 (16.7%) Candida tropicalis, 18 (16.7%) Candida krusei, 16 (14.8%) Candida glabrata and 11 (10.2%) Candida dubliniensis. According to age distribution, 27 years was the mean age. Pregnancy trimester distribution among patients was as follows: 21 (19.4%) patients were in their first trimester, 65 (60.2%) patients were in their second trimester and 22 (20.4%) patients were in the third trimester. Susceptibility of fluconazole was determined as follows: 33.3% of the Candida isolates were sensitive, 4.6% were susceptible dose dependent (SDD) and 62% were resistant. Susceptibility of Candida spp. with respect to nystatin in patients with VVC was as follows: 25% were sensitive, 16.7% were SDD and 58.3% were resistant. Susceptibility of clotrimazole was analyzed, and it was sensitive in 21.3% of patients, SDD in 19.4% of patients and resistant in 59.3% of patients. Voriconazole susceptibility was recorded to be sensitive in 85.2% of patients, SDD in 4.6% of patients and resistant in 10.2% of patients suffering from VVC. Susceptibility results for itraconazole in patients with VVC were as follows: 42.6% of patients were sensitive, 16.7% of patients were SDD, and 40.7% of patients were resistant. Conclusion: In this study, frequency of VVC was noted to be high in the second trimester of pregnancy, with the highest frequency of C. albicans isolated, followed by C. tropicalis and C. krusei. Antifungal susceptibility testing revealed that fluconazole was exceedingly resistant against Candida species (62%), followed by clotrimazole (59.3%) and nystatin (58.3%). On the contrary, voriconazole had the highest antimicrobial activity against Candida species (85.2%).
Archivos de medicina (Manizales), 2018
Objective: identify the vaginal colonizing Candida species and VVC species, predisposing factors and susceptibility against fluconazole in pregnant women attending gynecological outpatient of a maternal clinic in Cartagena (Colombia). Vulvovaginal candidiasis (VVC) is a common infection that affects a large proportion of women of childbearing age. It is estimated that about 75% of healthy women have had at least one episode of VVC in her life. Vaginal colonization by Candida spp. can vary from 10 to 17% and this is increased by 35% during pregnancy. The epidemiological behavior of Candida in VVC tends to be variable and this will depend on the level of vaginal estrogens, conditions of immunosuppression or chronicity of the process. Materials and Methods: the laboratory study included the direct examination of vaginal swabs, by fresh and differential staining of smears and cultures. The isolated species were identified by phenotypic tests and by multiplex PCR and CLSI M27-A3 microdilution method was used to evaluate susceptibility to fluconazole. Results: the frequent clinical diagnosis of bacterial vaginosis, did not correspond with the laboratory diagnosis in which predominated the intermediate biota. The results showed Candida albicans as the most common isolated species, followed by Candida tropicalis and Candida krusei. Candida colonization occurred in 71.4% and 28.6% of the population was diagnosed with vaginal candidiasis. All isolates were susceptible to fluconazole. Conclusion: The most common factors for colonization were related to clothing and for vaginal candidiasis to the use of vaginal lubricants.
Indian Journal of Microbiology Research, 2016
Aim/Objectives: To determine the predominant candidal species in Vulvovaginal Candidiasis. To find out the antifungal susceptibility pattern of the candidal isolates and to assess the risk factor associated with Vulvo-Vaginal Candidiasis (VVC). Methods: A total of 100 high vaginal swabs (HVS) were collected from women suspected of having Candidal Vulvovaginitis from May 2014 to February 2015. Wet mount preparations in potassium hydroxide (KOH) and Gram-stained smears were performed directly on specimens. Cultures for Candida species were done using Sabouraud's dextrose agar (SDA) at room temperature (25-28ºC). Antifungal susceptibility of the Candida species to Amphotericin B, Fluconazole and Ketoconazole was assessed using the NCCLS guidelines on Mueller Hilton agar. Results: The incidence of non albicans (60%) was significantly higher than the Candida albicans (40%) which was found to be sensitive to Fluconazole (95%) followed by Amphotericin B (85%). The common presenting symptoms of vulvovaginitis found to be thick white vaginal discharge followed by itching pruritus. Conclusion: The predominant candidal species in vulvovaginitis was non-albicans (candida tropicalis). Candida was most sensitive to fluconazole.
Mycoses, 2016
To evaluate the frequency of yeast, bacteria or protozoa in pregnant women and to correlate the possible associations of these microorganisms and their relationships with vulvovaginitis (VV) and cervicitis. Vaginal specimens were collected and prepared for smears in microscope slides for the evaluation of yeast, Trichomonas vaginalis and bacteria. Samples were cultured in specific culture medium. Cervical specimens were used to investigate the presence of Neisseria gonorrhoeae, Chlamydia trachomatis, Ureaplasma spp. and Mycoplasma hominis. We enrolled 210 pregnant women, aged 10-42 years old. Of them, 38.1% were symptomatic. Symptoms were most prevalent in the second and third trimesters of pregnancy coincident with a major prevalence of microorganisms. In this study, 39.5% of pregnant women had normal microbial biota and symptoms of VV due to non-infectious causes were observed (6.2%). The occurrence of vulvovaginal candidiasis was 25% and Candida albicans with a prevalence of 80.7% was the dominant species (P = 0.005) while non-albicans Candida species and other yeast were more common in asymptomatic ones (P = 0.0038). The frequency of bacterial vaginosis, T. vaginalis, C. trachomatis and N. gonorrhoeae were 18.1%, 1.4, 1.4% and 0.5% respectively.
Research Square (Research Square), 2019
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. Background Candida species, which are part of the normal flora in the vulvovagina, may cause opportunistic infections under various circumstances that compromise host immunity. Candida spp. subsist in symbiotic relationship with vaginal microbiota, therefore asymptomatic colonization is common and may persist for years. The rate of genital Candida colonization ranges from 20% in asymptomatic