Drug Resistance and Biofilm Formation in Candida Species of Vaginal Origin

Tahereh  Alikhani; Roshanak Daie  Ghazvini; Mehdi  Mirzaii; Seyed Jamal  Hashemi; Mozhgan  Fazli; Zahra  Rafat; Davoud  Roostaei; Pegah  Ardi; Hasti  Kamali Sarvestani; Mahdi  Zareei

doi:10.18502/ijph.v51i4.9253

Tahereh Alikhani Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Roshanak Daie Ghazvini Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Mehdi Mirzaii Department of Microbiology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
Seyed Jamal Hashemi Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Mozhgan Fazli Department of Microbiology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
Zahra Rafat Department of Medical Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
Davoud Roostaei Department. of Pharmacology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
Pegah Ardi Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Hasti Kamali Sarvestani Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Mahdi Zareei Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/ijph.v51i4.9253

Keywords: Vulvovaginal candidiasis; Biofilm; Candida albicans; Candida glabrata; Azole antifungals

Abstract

Background: Candida species are normal vaginal flora in healthy women, which can cause vulvovaginal candidiasis (VVC). The formation of biofilm is a cause of drug resistance in Candida species of vaginal origin. We aimed to specify Candida species cause VVC, detect their biofilm-forming ability, and antifungal susceptibility pattern.

Methods: Overall 150 vaginal samples were collected from suspected cases of referring to Bahar Hospital of Shahroud, Iran between Jan 2018 and Jan 2019. Samples were cultured on Sabouraud dextrose agar (SDA), Chrome gar Candida and Corn meal agar (CMA). PCR-RFLP was performed to confirm the identification. Biofilm formation of the identified species was measured by the Crystal Violet method. The susceptibility to fluconazole, clotrimazole, and miconazole was determined based on the CLSI document M27-A3.

Results: Of 50 women (33.3%) were suffering from VVC. C.albicans was the predominant species isolated in this study (n=39, 78%) followed by C. glabratia (n=11, 22%). In addition, in 25 (50%) of positive samples, biofilm formation was determined. The mean MIC of fluconazole and clotrimazole for C. albicans was 5.02 μg /mL and 3.92 μg /mL, respectively. Furthermore, the mean MIC related to these drugs for C. glabrata was 12.45 μg / mL and 4.1μg / mL, respectively. The mean diameter of miconazole inhibition zone for C. albicans and C. glabra isolates was 25.13 mm and 24.5mm, respectively and all of them were susceptible to this drug.

Conclusion: C.albicans was the predominant Candida species isolated from patients with VVC and also was the predominant biofilm producer species.