Identification and pattern of antifungal susceptibility of Candida species isolated from cases of vaginitis in a tertiary care hospital in India

Gulnaz Bashir; Insha Altaf; Rabia Khurshid; Tufail Ahmed; Aamir Ali; Sofia Zaffar

doi:10.18502/ijm.v15i2.12484

Gulnaz Bashir Department of Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
Insha Altaf Department of Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
Rabia Khurshid Department of Gynecology and Obstetrics, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
Tufail Ahmed Department of Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
Aamir Ali Department of Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
Sofia Zaffar Department of Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India

DOI: https://doi.org/10.18502/ijm.v15i2.12484

Keywords: Candidiasis; Vaginitis; Resistance; Antifungals; Reproductive health

Abstract

Background and Objectives: Vulvovaginal candidiasis (VVC) is one of the most frequent reasons for gynecological consul- tations. Candida albicans is responsible in the majority of cases. Lately, VVC caused by non-albicans Candida spp. (NAC), which are resistant to routinely used antifungals, is on the rise. This study was designed to determine the prevalence of Candida in patients suffering from vaginitis and to assess the predisposing factors along with identification of Candida species and evaluation of their susceptibility profile.

Materials and Methods: High vaginal swabs were collected from 225 women. Sample processing consisted of Gram stain and culture onto Sabouraud’s dextrose agar and HiChrom Candida Differential agar. Isolates were identified and speciated using VITEK2 Compact System. Susceptibility testing was done using VITEK2 AST-Y S08 cards and disc diffusion.

Results: Candida spp. were isolated from 94 (41.8%) of the cases. C. albicans was the predominant species (71.6%) fol- lowed by other NAC spp. (28.4%). Pregnancy and diabetes were the most frequently implicated risk factors (67.1% and 44.4%). High resistance was observed in NAC spp. as opposed to C. albicans to all antifungal agents tested.

Conclusion: Empirical therapy with routinely used antifungals can be initiated for C. albicans. In the case of NAC spp., identification should be followed by susceptibility testing.