Characterization of Candida species isolated from vulvovaginal candidiasis by MALDI-TOF with in vitro antifungal susceptibility profiles

Abstract

Background and Purpose: Vulvovaginal candidiasis (VVC) is an opportunistic infection due to Candida species, one of the most common genital tract diseases among reproductive-age women. The present study aimed to investigate the prevalence of VVC among non-pregnant women and identify the epidemiology of the involved Candida species with the evaluation of antifungal susceptibilities.
 Materials and Methods: Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) was performed to identify Candida species isolated from the genital tract of 350 non-pregnant women. Moreover, antifungal susceptibility testing was performed according to the Clinical and Laboratory Standards Institute broth microdilution method guidelines (M27-A3 and M27-S4).
 Results: Vaginal swab cultures of 119 (34%) women yielded Candida species. Candida albicans was the most frequently isolated species (68%), followed by Candida glabrata (19.2%). Voriconazole was the most active drug against all tested isolates showing an MIC50/MIC90 corresponding to 0.016/0.25 µg/mL, followed by posaconazole (0.031/1 µg/mL). Overall, resistance rates to fluconazole, itraconazole, and voriconazole were2.4%, 4.8% and, 0.8% respectively. However, posaconazole showed potent in vitro activity against all tested isolates.
 Conclusion: Results of the current study showed that for the effectual therapeutic outcome of candidiasis, accurate identification of species, appropriate source control, suitable antifungal regimens, and improved antifungal stewardship are highly recommended for the management and treatment of infection with Candida, like VVC.

Resistance of Candida isolates to antifungals using VITEK system at the Rodolphe Mérieux Centre, Bamako, Mali

“…Our findings are different from those of Ing-Moi hii et al, [15] reporting the resistance of 2.8% of C. glabrata to micafongin, 17.4% and 1.6% resistance respectively of C. In addition, in Burkina Faso, higher rates of resistance have been observed for fluconazole (66.5%), itraconazole (52.3%), ketoconazole (22.9%) and 32.0% to amphotericin for Candida isolates in vulvovaginal and oral environments [18]. In Iran using MALDI-TOF the overall resistance rates to fluconazole, itraconazole, and voriconazole were respectively 2.4%, 4.8% and, 0.8% [19]. VITEK system is fast and good but some error have been reported in determination of vitro antifungals susceptibility using VITEK automated system [20].…”