Identify and sensitivity to antifungal drugs of Candida species causing vaginitis isolated from vulvovaginal infected patients in Sana'a city

Abdullah Al-mamari; Mahmoud Al-buryhi; Mohammed A. Al-heggami; Sadeq Al-hag

Abstract

Identify and sensitivity to antifungal drugs of Candida species causing vaginitis isolated from vulvovaginal infected patients in Sana'a city

Author(s): Abdullah Al-mamari, Mahmoud Al-buryhi, Mohammed A. Al-heggami and Sadeq Al-hag*

Recently, antifungal susceptibility testing has become more important because of the increasing incidence of both fungal infections and antifungal drug resistance. Candida vaginitis is a common fungal infection among adult women and it has been estimated that 75% of all adult women experience at least one period of vulvovaginal candidiasis in their lifetime. Several predisposing factors, such as diabetes mellitus, using contraceptive, pregnancy, and broad-spectrum antibiotics are reported as main risk factors for the infection. While, the main etiologic agent of vulvovaginal candidiasis is Candida albicans, more antifungal resistance has been reported among non-albicans species. The aim of the present study was toidentify Candida species anddeterminesusceptibility patterns of vaginal isolates of Candida to antifungal drugs including, clotrimazole, miconazole, terbinafine,nystatin, itraconazole, fluconazole, ketoconazole, and econazole. In the present study, 150 vulvovaginal isolates of Candida species were investigated for performing identify and susceptibility tests. The isolates were kept in sterile distilled water at 4°C in the medical Microbiology laboratory of Al-thourah hospital. All isolates were re-identified using standard methods, germ tube test, CHROMagar Candida test and microscopic characteristics on corn meal by preparation high media. Identification was based on colonies producing a green coloration on CHROMagar and presence chlamydosporse on corn meal agar test which were presumptively identified as C. albicans. Disk diffusion method was used to evaluate susceptibility patterns. Paper disks containing clotrimazole, miconazole, itraconazole, fluconazole, ketoconazole, econazole, nystatin and terbinafine were applied for susceptibility tests. A total of 141 women were included in the study and yeasts were isolated in 93 (65.95%), of them C. albicans was the most common species among the isolates followed by C. glabrata 18 (12.76%), C. tropicalis 24 (17.02%) and C. krusei 6 (4.25%) that were isolated from vaginal infected patients.In the present study, we founded that 5 isolates of C. krusei were sensitive to ketoconazole, clotrimazole and miconazole. In addition both isolates were resistant to fluconazole, nystatin, econazole and terfinafine. Only 9 isolate of C. tropicalis was sensitive to miconazole and terbinafine and two isolates to clotrimazole. Highest sensitivity of C. albicans to antifungal drugs was seen against miconazole (89 of 93 isolates) followed by, clotrimazole (81), terbinafine (38) and ketoconazole (13) whereas 73 isolates were resistant to fluconazole and econazole antifungals. 17 out of 18 isolates of C. glabrata were resistant to fluconazole, whereas all isolates were sensitive to miconazole. Antifungal sensitivity testing suggests that vaginal isolates of Candida were most sensitive to miconazole, clotrimazole, and terbinafine, and least sensitive to econazole and fluconazole.

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