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.

Molecular diagnosis and antifungal resistance and biofilm production profiles among Candida species isolated from immunocompromised patients at Menoufia University Hospitals

2020 ◽  
Vol 29 (3) ◽  
pp. 37-45
Author(s):  
Mabrouk M Ghonaim ◽  
Azza Z. Labeeb ◽  
Alyaa I. Eliwa ◽  
Eman H. Salem
Keyword(s):  
Candida Species ◽  
Biofilm Formation ◽  
Antifungal Susceptibility ◽  
High Sensitivity ◽  
Antifungal Resistance ◽  
Common Source ◽  
Immunocompromised Patients ◽  
University Hospitals ◽  
Biofilm Production ◽  
Vitek 2

Background: Accurate and rapid identification of Candida species is necessary for proper diagnosis and treatment of candidiasis due to emergences of drug-resistant strains especially among immunocompromised patients. Objectives: Identification of Candida clinical isolates to the species level using different phenotypic and molecular methods. Biofilm-forming ability and antifungal resistance were also studied. Methodology: Sixty-nine Candida strains were isolated from 220 immunocompromised patients. Identification was performed using chromogenic Candida agar, VITEK 2 system and multiplex polymerase chain reaction (PCR). Biofilm formation was detected by the tube method and antifungal susceptibility was tested using the VITEK2 system. Results: The most common source of Candida isolates was from urine (33.3%) and ICUs (56.6%). VITEK 2 system detected 9 spp.: C. albicans (34.8%), C. tropicalis (21.7%), C. famata (8.7%), C. lusitaniae (7.2%), C. cruzi (7.2%), C. ciferri (5.8%), C. dubliniensis (5.8%), C. parapsilosis (5.8 %) and C. glabrata. Candida isolates showed high resistance to flucytocine (49.3%), and high sensitivity to fluconazole, micafungin, voriconazole and caspofungin (88.4%, 81.2% and 81.2 % respectively). Only 30.4% of all Candida isolates were biofilm producers. There was a positive relationship between antifungal resistance and biofilm formation among Candida isolates. Conclusion: C. albicans was the predominant species. Chromogenic Candida agar and VITEK 2 system were valuable tests compared to PCR in speciation of Candida isolates. Antifungal susceptibility was significantly related to biofilm production and its evaluation is important for proper treatment..

scholarly journals THE PREVALENCE OF VULVOVAGINAL CANDIDIASIS IN PREGNANT WOMEN ATTENDING SEVERAL HOSPITALS IN SANA’A, YEMEN

2020 ◽  
Author(s):  
Abdulrahman Humaid ◽  
Saeed M Alghalibi ◽  
Anes Al-Mahbashi ◽  
Aml AL-Arossi ◽  
Wadhah Hassan Edrees
Keyword(s):  
Pregnant Women ◽  
Peer Review ◽  
Candida Species ◽  
Antifungal Susceptibility ◽  
Common Species ◽  
Vulvovaginal Candidiasis ◽  
University Hospital ◽  
Vaginal Candidiasis ◽  
Microbiological Methods ◽  
E Mail

Candida species are opportunistic yeasts affecting the genitourinary tract which causes the vulvovaginal candidiasis in the most female especially in developing countries. This study aims to determine the prevalence of vulvovaginal candidiasis caused by Candida species causing among pregnant women in Sana'a City, Yemen. This study was carried out at the department of microbiology of AL-Kuwait University Hospital. 250 vaginal swabs were collected and cultured on Sabouraud dextrose agar. Candida species identification and antifungal susceptibility testing were determined according to standard microbiological methods. The results showed that out of 250 samples, 63(25.2%) were positive for Candida species. It was found that the C. albicans (68.3%) was the most common species isolated followed by non-albicans species that are C. tropicalis (20.6%), C. glabrata (6.3%), and C. kefyr (4.8%). Also, it was recorded that the highest prevalence of Candida species was within group aged of 36-46 year. Susceptibility tests revealed that the most isolated species of C. andida were sensitive to nystatin (95%). miconazole was the next effective drug with 64% sensitive followed by amphotericin B (29%) and clotrimazole (24%). But only 6% of the isolates were sensitive to fluconazole. It can be concluded that the vulvovaginal candidiasis are quite common in Yemen country with a high prevalence. Also, the nystatin remains the effective agent against all isolated of Candida species. In contrast, the increase resistance of Candida species to fluconazole that commonly used antifungal is an alarming increase of vaginal candidiasis caused by antifungal-resistant Candida species. Peer Review History: UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file Average Peer review marks at initial stage: 5.0/10 Average Peer review marks at publication stage: 8.0/10 Reviewer(s) detail: Name: Dr. Hassan A.H. Al-Shamahy Affiliation: Sana'a University, Yemen E-mail: [email protected]   Name: Dr. Tamer Mohamed Ali El Habibi Affiliation: Suez Canal University, Egypt. E-mail: [email protected]   Name: Rola Jadallah Affiliation: Arab American University, Palestine E-mail: [email protected] Comments of reviewer(s): Similar Articles: AN EXHAUSTIVE STATISTIC ON CURRENT MUCOADHESIVE INTRAVAGINAL DRUG DELIVERY METHODOLOGIES TETANUS IMMUNIZATION AMONG PREGNANT WOMEN: COVERAGE RATE AND RATE OF PROTECTION AT TIME OF DELIVERY

scholarly journals Prevalence and Antifungal Susceptibility patterns of Candida Isolated on CHROMagarTMCandida at a Tertiary Referral Hospital, Eastern Uganda

2019 ◽  
pp. 1-6
Author(s):  
Watsemwa Juliet Jane ◽  
Jacob Stanley Iramiot ◽  
John Bosco Kalule
Keyword(s):  
Pregnant Women ◽  
Amphotericin B ◽  
Candida Species ◽  
Vaginal Discharge ◽  
Antifungal Susceptibility ◽  
Vulvovaginal Candidiasis ◽  
Referral Hospital ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital ◽  
Eastern Uganda

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 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). Candida albicans showed resistance to amphotericin B (70.63%, 89/126), clotrimazole (11.9%, 15/126), nystatin (3.17%, 4/126), fluconazole (23.02%, 29/126), and itraconazole (17.46%, 22/126). Among the non-albican Candida species, C. glabrata showed resistance to fluconazole (100% ,24/24), amphotericin B (100% ,24/24), clotrimazole (14.29%, 18/24), nystatin (1.59%, 2/24), and itraconazole (18.25%, 23/24). C. krusei showed resistance to fluconazole (100%, 1/1), amphotericin B (100%,1/1), and itraconazole (100%, 1/1). Conclusion: The candida species commonly associated with VVC in Eastern Uganda are C. albicans C. glabrata and C. krusei. Antifungal resistance was highly prevalent among the candida isolated. 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 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 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 Analysis of Сandida species distribution isolated from women with vulvovaginal candidiasis and their antifungal susceptibility profile

2021 ◽  
Vol 9 (6) ◽  
pp. 225-229
Author(s):  
O.S. Burduniuc ◽  
E.I. Bîrcă ◽  
A.M. Burduniuc ◽  
M.V. Bivol ◽  
O.S. Iacon
Keyword(s):  
Species Distribution ◽  
Candida Species ◽  
Antifungal Susceptibility ◽  
Common Species ◽  
Resistance Rate ◽  
Vulvovaginal Candidiasis ◽  
Automated System ◽  
Clinical Samples ◽  
Bacterial Strains ◽  
Candida Spp

Background. Candida species is usually a commensal fungus residing in the vagina, in about 30 %–50 % of healthy adults and remains the most common agent isolated from clinical samples of patients diagnosed with vulvovaginal candidiasis (VVC). Culture is not recommended for all patients on a routine basis but is informative for the exclusion of non-albicans infections resistant to azoles, or recurrent VVC. Identification of Candida species and antifungal susceptibility testing are key elements in the correct management of recurrent VVC. The authors of this paper aimed to study the spectrum of pathogenic Candida species. The antifungal sensitivity patterns of the isolated strains during the years 2017-2019 are also presented. Material and methods. A descriptive study of Candida species distribution and antifungal susceptibility profile was performed. Identification of isolated Candida species was performed by the MALDI-TOF MS, bacterial strains by Vitek 2 automated system (BioMérieux) and antifungal susceptibility profiles by Fungitest (Bio-Rad). Results. Of the 1030 recovered strains, C. albicans species predominated - 83.8% and Candida non albicans -16.2%. The most common species of the Candida non-albicans, were C.glabrata (7.5%). Also, it was observed that in 56.6% of the cases C. albicans presented bacterial associations. The most common microbial association was C. albicans and S.aureus (26.6%), followed by C. albicans and E.coli (20.8%). Candida spp. showed moderate antifungal resistance. The resistance rate of C. albicans isolates to miconazole, fluconazole and itraconazole was 25.5%, 17.0% and 11.4% compared to non-albicans Candida strains which showed a resistance rate of 10,8%, 14.4% and 10%, respectively. Conclusions. C. albicans is the most frequently isolated species among patients with VVC, but there is also an increase share of non-albicans Candida species such as C. glabrata. C. albicans isolates showed higher indices of resistance, than Candida non-albicans.

scholarly journals Species distribution and susceptibility profiles of Candida species isolated from vulvovaginal candidiasis, emergence of C. lusitaniae

2019 ◽  
Author(s):  
Seyed Ebrahim Hashemi ◽  
Tahereh Shokohi ◽  
Mahdi Abastabar ◽  
Narges Aslani ◽  
Mahbobeh Ghadamzadeh ◽  
...  
Keyword(s):  
Candida Species ◽  
Antifungal Agents ◽  
Antifungal Susceptibility ◽  
Common Species ◽  
Cross Sectional Study ◽  
Vulvovaginal Candidiasis ◽  
Epidemiological Surveillance ◽  
Drug Pressure ◽  
Cross Sectional ◽  
Overall Resistance

Background and Purpose: The aim of the current study was to investigate the epidemiology of vulvovaginal candidiasis (VVC) and recurrent VVC (RVVC), as well as the antifungal susceptibility patterns of Candida species isolates.Materials and Methods: A cross-sectional study was carried out on 260 women suspected of VVC from February 2017 to January 2018. In order to identify Candida species isolated from the genital tracts, the isolates were subjected to polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) using enzymes Msp I and sequencing. Moreover, antifungal susceptibility testing was performed according to the Clinical and Laboratory Standards Institute guidelines (M27-A3).Results: Out of 250 subjects, 75 (28.8%) patients were affected by VVC, out of whom 15 (20%) cases had RVVC. Among the Candida species, C. albicans was the most common species (42/95; 44.21%), followed by C. lusitaniae (18/95; 18.95%), C. parapsilosis (13/95; 13.69%),  C. glabrata (8/95; 8.42%), C. kefyr (6/95; 6.31%), C. famata (5/95; 5.26%), C. africana (2/95; 2.11%), and C. orthopsilosis (1/95; 1.05%), respectively. Multiple Candida species were observed in 28% (21/75) of the patients. Nystatin showed the narrowest range of minimum inhibitory concentration (MIC) (0.25-16 μg/ml) against all Candida strains, whereas fluconazole (0.063-64 μg/ml) demonstrated the widest MIC range. In the current study, C. lusitaniae, as the second most common causative agent of VVC, was susceptible to all antifungal agents. Furthermore, 61.1% of C. lusitaniae isolates were inhibited at a concentration of ≤ 2 μg/ml, while38.9% (n=7)of them exhibited fluconazole MICs above the epidemiologic cutoff values (ECV). Candida species showed the highest overall resistance against fluconazole (61.3%), followed by itraconazole (45.2%) and caspofungin (23.7%). All of C. albicans strains were resistant to itraconazole with a MIC value of ≥ 1 μg/ml; in addition, 87.5% of them were resistant to fluconazole. Moreover, 100% and 87.5% of C. glabrata strains were resistant to caspofungin and fluconazole, respectively.Conclusion: As the findings revealed, the majority of VVC cases were caused by non-albicans Candida species which were often more resistant to antifungal agents. Candida lusitaniae generally had fluconazole MICs above the ECV. Given the propensity of C. lusitaniae to develop resistance under drug pressure, antifungals should be administered with caution. The emergence of these species justify the epidemiological surveillance surveys to watch out the distribution of yeast species.

Comparison of the VITEK 2 antifungal susceptibility system with Etest using clinical isolates of Candida species

2017 ◽  
Vol 34 (3) ◽  
pp. 171-174 ◽  
Author(s):  
Wadha Alfouzan ◽  
Tahani Al-Enezi ◽  
Ebteehal AlRoomi ◽  
Vayalil Sandhya ◽  
Rachel Chandy ◽  
...  
Keyword(s):  
Candida Species ◽  
Antifungal Susceptibility ◽  
Clinical Isolates ◽  
Vitek 2

scholarly journals Distribution and antifungal susceptibility of Candida species in patients with increased risk for fungal infections

2016 ◽  
Vol 62 (1) ◽  
pp. 65-76
Author(s):  
Gordana Mirchevska ◽  
Maja Jurhar Pavlova ◽  
Elena Trajkovska-Dokic ◽  
Zaklina Cekovska ◽  
Gordana Jankoska ◽  
...  
Keyword(s):  
Blood Culture ◽  
Amphotericin B ◽  
Critically Ill Patients ◽  
Candida Species ◽  
Antifungal Agents ◽  
Fungal Infections ◽  
Antifungal Susceptibility ◽  
Clinical Specimens ◽  
Fourth Group ◽  
Increased Risk

Candida species are opportunistic yeasts that can be a serious threat for immunocompromised and critically ill patients, and a cause for increased morbidity and mortality in hospitalized patients. The aim of this study was to determine the frequency and distribution of different Candida species in clinical specimens in patients with increased risk for fungal infections, and to determine the antifungal susceptibility profile of invasive Candida species to antifungal agents. During a two year period, clinical specimens from 120 patients divided into 4 groups were analysed at the Institute of microbiology and parasitology, Faculty of Medicine, Skopje, Republic of Macedonia. Each of these 4 groups consisted of specimens from 30 patients, with primary immune deficiency, critically ill patients treated in the intensive care units (ICU), patients with mucosal candidiasis only, and patients with cystic fibrosis. All specimens were investigated with conventional mycological methods. Identification of Candida species was performed with VITEK-2 system (bioMérieux, France). E-test strips of fluconazole, voriconazole, amphotericin B and caspofungin (AB bioMerieux, France) were used for determination of the antifungal susceptibility profile. In this study, a total of 115 isolates of Candida species were confirmed in different clinical specimens (91 isolates from mucosal surfaces and 24 isolates from blood culture). Colonisation of mucosal membranes of gastrointestinal, respiratory and/or urinary tracts was registered in 56.67% (17/30), 56.67% (17/30), 90% (27/30) and 100% (30/30) of the specimens in the first, second, third and fourth group respectively. In all four groups of patients, the following Candida species were confirmed: C. albicans - 55%, C. glabrata - 17.6%, C. parapsilosis - 7.7%, C. tropicalis - 6.6%, unidentified Candida species - 4.4%, C. dubliniensis - 3.3%, C. kefyr - 2.2%, and one isolate of C. rugosa, C. pelliculosa and C. krusei each. Positive blood culture was registered in 23.33% specimens from the first group, 43.33% in the second group, 23.08% of the third group, and in one specimen of the fourth group. The most frequent isolates from blood culture were C. tropicalis and C. krusei, followed by C. albicans, C. parapsilosis and C. tropicalis, and in the second group C. albicans and C. pelliculosa were equally distributed, followed by C. parapsilosis and C. glabrata. All invasive isolates of Candida species were susceptible to amphotericin B, voriconazole and caspofungin. Resistance to fluconazole was registered in 8.3% (2/24) of all confirmed Candida species. Dose-dependent susceptibility to fluconazole was confirmed in 46% (11/24) of the isolates. Our study confirms high prevalence of colonisation and candidemia with non-albicans Candida species. Resistance to antifungal agents was registered only in two isolates of C. krusei. An epidemiological study is necessary for surveillance of dynamics of candidemia and antifungal susceptibility profile of invasive isolates of Candida species in our patients.

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