scholarly journals Antifungal Resistant in Non-Albicans Candida Species are Emerging as a Threat to Antenatal Women with Vulvovaginal Candidiasis

2019 ◽  
Vol 12 (3) ◽  
pp. 1369-1378
Author(s):  
Kanishka Hrishi Das ◽  
V. Mangayarkarasi ◽  
Maitrayee Sen
Keyword(s):  
Candida Species ◽  
Antifungal Susceptibility ◽  
Economic Cost ◽  
Vulvovaginal Candidiasis ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Disk Diffusion Method ◽  
Vaginal Swabs ◽  
Empirical Antifungal Therapy ◽  
Considerable Morbidity

Vulvovaginal candidiasis (VVC) is caused by Candida species. It has been associated with impact on economic cost. Currently, Non-albicans Candida species are more resistant to azoles and get converted from harmless to pathogenic state due to several virulence factors. Monitoring of the antifungal susceptibility pattern is important to know the resistant pattern of Candida species. Thus the objective of this research was to the identification of Candida in species level and to evaluate the antifungal resistance pattern in Candida species isolated from the vaginal discharge of antenatal women with vulvovaginal candidiasis. This prospective study was done in SRM MCH & RC, Chennai, India, from March 2017 and December 2018. An aggregate of 342 vaginal swabs were gathered from antenatal women of symptomatic and asymptomatic VVC. Antifungal susceptibility test was done by the disk diffusion method as per the CLSI guidelines. A total of 112 Candida species were isolated from 342 high vaginal swabs. Out of 112 Candida isolates, 65 (58%) were Non-albicans Candida (NAC) and 47 (42%) were C. albicans. In this study, 103/112(91.6%) of Candida isolates had the highest sensitivity to voriconazole and 26/112(23.2%) of Candida isolates had the highest resistance to miconazole. NAC species are emerging as potential threats to cause infection and posing a therapeutic challenge. Early empirical antifungal therapy and further research to improve diagnostic, prevention and therapeutic strategies are necessary to reduce the considerable morbidity and mortality.

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.

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

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.

scholarly journals Changing Trends of Vulvovaginal Candidiasis

2014 ◽  
Vol 6 (01) ◽  
pp. 028-030 ◽  
Author(s):  
Doddaiah Vijaya ◽  
Tumkur Anjaneya Dhanalakshmi ◽  
Sunanda Kulkarni
Keyword(s):  
Antifungal Susceptibility ◽  
Cost Effective ◽  
Common Species ◽  
Vulvovaginal Candidiasis ◽  
Diffusion Method ◽  
Gram Stain ◽  
Cost Effective Method ◽  
Vaginal Swabs ◽  
Conventional Methods ◽  
Common Infections

ABSTRACT Introduction: Vulvovaginal candidiasis is one of the most common infections seen in women. Materials and Methods: A total of 300 symptomatic women were studied. High vaginal swabs collected from each patient were processed by Gram stain, culture on Sabourauds dextrose agar and CHROM agar plates. Isolates were identified and speciated using conventional methods and by the color of the colonies on the CHROM agar. Antifungal susceptibility was performed by disc diffusion method for fluconazole (25 μg) and voriconazole (1 μg) discs as per Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: Vulvovaginal candidiasis was found in 53 (17.7%) of cases. Gram stain was positive in 22 (41.41%) of culture positives. Speciation of isolates by conventional and CHROM agar methods showed similar results. C. albicans 35 (66.0%) was the most common species isolated followed by C. tropicalis 14 (26.4%), C. krusei 2 (3.8%), C. parapsilosis and C. glabrata in 1 (1.9%) case each. Sensitivity to fluconazole was found in 91.4% of C. albicans, 57.1% of C. tropicalis and 50.0% of C. krusei. Sensitivity to voriconazole was seen in 91.4% of C. albicans, 85.7% of C. tropicalis and 50.0% of C. krusei. C. parapsilosis and C. glabrata were found sensitive only to voriconazole. Conclusion: CHROM agar has the advantage of being rapid, simple and cost effective method as compared to conventional methods in speciation of Candida. Routine susceptibility testing of Candida isolates help in selecting the most appropriate antifungal agent for vulvovaginal candidiasis.

scholarly journals Prevalence and Antifungal Susceptibility Pattern of Candida Isolates from Women with Recurrent Vulvovaginal Candidiasis in Ghana - A Review of Laboratory Reports.

2020 ◽  
Author(s):  
George Antepim Pesewu ◽  
Patrick Kwame Feglo ◽  
Richard Kwaku Boateng ◽  
Samuel Adetona Fayemiwo
Keyword(s):  
Antifungal Susceptibility ◽  
Rflp Analysis ◽  
Vulvovaginal Candidiasis ◽  
Diffusion Method ◽  
Childbearing Age ◽  
Candida Spp ◽  
Disk Diffusion Method ◽  
Recurrent Vulvovaginal Candidiasis ◽  
Pcr Rflp ◽  
Common Infection

Abstract Vulvovaginal candidiasis (VVC) is a common infection among women of childbearing age, and few of these women experience recurrent vulvovaginal candidiasis (RVVC). The study was aimed at determining the virulent factors, and antifungal susceptibility of the Candida species isolated from women with RVVC attending the Nkawie Government Hospital, Ashanti-Region, Ghana. Over a 6–month period (October 2016 to March 2017), a total of 288 women with RVVC were evaluated. Isolation of the yeast was performed after the inoculation of the vaginal specimens onto Sabouraud Dextrose Agar (SDA), and incubated for 24-48 hours at 37oC. The isolates were identified by standardized conventional methods. The enzymatic activities of esterase, phospholipase, haemolysis and biofilm production were evaluated for the identification of the yeast isolates. Susceptibility to antifungal agents was determined by using the Kirby-Bauer disk diffusion method. Azole resistant isolates were further tested for ERG11 gene which encodes the enzyme (cytochrome P450 lanosterol 14-α-demethylase) by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. Vaginal swabs cultures of 200 women (64.4) from 288 samples yielded Candida species. Candida albicans was the commonest isolated specie (33.0%), followed by Candida glabrata (29.5 %), Candida tropicalis (23.0%), and Candida krusei (15.5%). Hemolysin production, phospholipase enzyme activity, and biofilms formation were found in 84.5%, 83%, 77.5%.of the isolates respectively. Most phospholipase producing Candida isolates also formed biofilms. All Candida spp isolated were susceptible to itraconazole while majority of them were resistant to voriconazole. ERG11 genes were detected in 11.1% of Azole resistant Candida species. There is a significant increase in the rate of antifungal resistance among the Candida isolates to fluconazole and voriconazole. There is need for continuous surveillance as well as antifungal susceptibility testing on the Candida spp to guide therapy. A larger epidemiological study is also advocated to determining the degree of spread of ERG11 genes.

scholarly journals Epidemiological and Microbiological Study of Onychomycosis

2021 ◽  
Author(s):  
Sunita Kabi ◽  
Bichitrananda Swain ◽  
Swati Jain
Keyword(s):  
Candida Species ◽  
Susceptibility Testing ◽  
Antifungal Susceptibility ◽  
Nail Plate ◽  
Laboratory Diagnosis ◽  
Antifungal Susceptibility Testing ◽  
Antifungal Drugs ◽  
Diffusion Method ◽  
Resistance Pattern

Introduction: Onychomycosis is a common fungal infection of nail. It may be caused by dermatophytes, non-dermatophytic moulds or yeasts involving nail bed, nail plate or matrix of nail. As the fungi show variable susceptibility to antifungal drugs and treatment requires long duration of antifungal therapy, so it’s prevalence as well as proper laboratory diagnosis and antifungal susceptibility testing is essential for effective therapy. Aim: To find the prevalence of onychomycosis with demography along with various aetiology and the suitable antifungal drugs used for treatment. Materials and Methods: For this prospective study, over a period of two years a total of 300 nail samples were processed in the Department of Microbiology at IMS and SUM Hospital, Bhubaneswar, Odisha, India. The wet mount for microscopic examination was prepared using 20% Potassium Hydroxide (KOH) and examined after overnight incubation. Culture was done in duplicate in Sabouraud’s Dextrose Agar (SDA) tubes; one with actidione and another without it and both were incubated at 25°C in Biological Oxygen Demand (BOD) incubator. Culture tubes growing yeasts were further subjected to speciation by germ tube test, culture on Chromogenic (CHROM) agar and on cornmeal agar. In-vitro antifungal susceptibility testing was performed against Candida species using disc diffusion method on Muller Hinton agar. Chi-square test was used for statistical analysis of the results. Results: Onychomycosis can affect a wide age group though seen commonly at 31-40 years equally in both male and females. Fingernail infection was observed mostly in female cases. It was caused by Candida species (66%), moulds (24%) and dermatophytes (10%) and out of Candida sp. C.albicans was the main culprit. Although all the Candida strains were susceptible to amphotericin B, still some of them showed resistance to the commonly used antifungals like fluconazole and itraconazole. Conclusion:Candida albicans was the most common aetiological agent which contributed for onychomycosis and showed a variable resistance pattern to the commonly used antifungals. Proper laboratory diagnosis and selection of antifungal drug is essential prior to institution of therapy for successful treatment of this disease.

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.

scholarly journals Detection of Pan drug resistance OXA-48 producing Providencia in an ICU patient for the first time in Nepal

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Ranjit Sah ◽  
Shusila Khadka ◽  
Gentle Sunder Shrestha ◽  
Subhash Acharya ◽  
Diptesh Aryal ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Pathogenic Bacteria ◽  
Antimicrobial Agents ◽  
Vital Signs ◽  
Carbapenem Resistance ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Common Mechanism ◽  
Disk Diffusion Method ◽  
Drug Resistance Pattern

Abstracts Background Resistance to antimicrobial agents of pathogenic bacteria has become a major problem in routine medical practices. Carbapenem resistance has long been increasing. The production of carbapenem- hydrolysing β-lactamases (carbapenamases), which include NDM, KPC, OXA-48, IMP-1 and VIM is the most common mechanism. Case presentation A 56 years old male presented with fever and mental changes with progressively decreasing sensorium for the last 3 days. He was admitted to Intensive care unit (ICU) with a diagnosis of meningoencephalitis. On day seven, he developed ventilator associated pneumonia due Klebsiella pnemoniae and Acinetobacter baumannii. He was on meropenem, but the isolates were susceptible to colistin, tigecyclin and amikacin solely. Hence, amikacin was started with addition of intravenous and nebulized colistin. Subsequently, vital signs improved with resolution of fever. However, on day 18, he developed fever once again with a drop in blood pressure. Inotropic support was maintained, and echinocandins and tigecycline were added to the regimen. Repeat blood and urine culture grew Providencia species, which were resistant to most of the drugs on phenotypic Kirby-Bauer disk diffusion method and are intrinsically resistant to colistin and tigecycline. Phenotypic detection of ESBL (combined disk method), MBL, KPCs, AmpC and co-producer were tested according to updated CLSI guideline and all were negative. But the Modified Hodges test was found to be positive. Consequenty, OXA-48 drug resistance pattern was brought into action by blank disc method according to A Tsakris et al., which revealed indentation of growth toward both EDTA and EDTA/PBA disk indicating production of OXA-48 carbapenamase. To confirm the resistance pattern we processed the isolated colonies for Xpert Carba-R (Cepheid) assay, which detected blaOXA-48 gene and confirmed the OXA-48 drug resistance pattern. Hence, the infecting organism was not susceptible to any of the antibiotics. The patient was kept under isolation and on 31th day of admission, he died of septic shock. Conclusions Carbapenamase production along with intrinsic colistin resistance in infecting bacterial pathogens can cause fatal outcomes in the resource limited countries like Nepal where new antibiotic combinations ceftazidime+ Avibactam, or aztreonam +avibactam are not available. Drug resistance patterns including OXA 48 producer should be characterized in all cases by standard phenotypic methods or by Xpert Carba-R assay and larger studies are required to know the exact burden of OXA 48 producer in Nepal.

scholarly journals Streptococcus agalactiae in pregnant women: serotype and antimicrobial susceptibility patterns over five years in Eastern Sicily (Italy)

2020 ◽  
Vol 39 (12) ◽  
pp. 2387-2396
Author(s):  
Carlo Genovese ◽  
Floriana D’Angeli ◽  
Valentina Di Salvatore ◽  
Gianna Tempera ◽  
Daria Nicolosi
Keyword(s):  
Pregnant Women ◽  
Antimicrobial Susceptibility ◽  
Streptococcus Agalactiae ◽  
Late Onset ◽  
Disk Diffusion ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Disk Diffusion Method ◽  
Defibrinated Sheep Blood ◽  
Disk Diffusion Test

AbstractStreptococcus agalactiae (also known Group B Streptococcus or GBS) represents the main pathogen responsible for early- and late-onset infections in newborns. The present study aimed to determine the antimicrobial susceptibility pattern and the capsular serotypes of GBS isolated in Eastern Sicily over 5 years, from January 2015 to December 2019. A total of 3494 GBS were isolated from vaginal swabs of pregnant women (37–39 weeks), as recommended by the Centers for Disease Control and Prevention. Capsular polysaccharide’s typing of GBS was determined by a commercial latex agglutination test containing reagents to serotypes I–IX. The antimicrobial resistance pattern of GBS was determined through the disk diffusion method (Kirby-Bauer) and the double-disk diffusion test on Mueller-Hinton agar plates supplemented with 5% defibrinated sheep blood, according to the guidelines of the Clinical and Laboratory Standards Institute. Serotypes III (1218, 34.9%) and V (1069, 30.6%) were the prevalent colonizers, followed by not typable (570, 16.3%) and serotypes Ia (548, 15.7%), Ib (47, 1.3%), II (40, 1.1%), and IV (2, 0.1%). All 3494 clinical isolates were susceptible to cefditoren and vancomycin. Resistance to penicillin, ampicillin, levofloxacin, clindamycin, and erythromycin was observed in 6 (0.2%), 5 (0.1%), 161 (4.6%), 1090 (31.2%), and 1402 (40.1%) of the strains, respectively. Most of erythromycin-resistant GBS (1090/1402) showed the cMLSB phenotype, 276 the M phenotype, and 36 the iMLSB phenotype. Our findings revealed a higher prevalence of serotype III and a relevant resistance rate, among GBS strains, to the most frequently used antibiotics in antenatal screening.

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