Microbiological and molecular screening of Candida spp. isolated from genital tract of asymptomatic pregnant women

Abstract

Introduction. Candida spp. may cause opportunistic infections called vulvovaginal candidiasis (VVC), which is estimated to be the second most common cause of vaginitis worldwide. Gap Statement. Under various circumstances, VVC could compromise pregnancy outcomes. Emerging data suggests that VVC during pregnancy may be associated with increased risk of complications and congenital cutaneous candidiasis. Aim. To assess the prevalence of Candida spp. in asymptomatic pregnant women and determine the susceptibility of the isolates to antifungal drugs. Methodology. In a prospective cohort, 65 high vaginal swab samples of consented pregnant women. Candida isolates were identified using both microbiological and molecular tools and drug susceptibilities were profiled. Results. The prevalence of VVC among our study participants was 37 %, 24 of the 65 asymptomatic pregnant women show Candida spp. colonization. C. albicans was the most common species 61 %, followed by C. glabrata 39 %. In addition, a significant fraction of the isolated colonies showed resistance to Fluconazole, with a ratio of 63 % for C. albicans isolates and 16 % for Candida glabrata isolates. Moreover, relative quantification of genes related to resistance to fluconazole, CDR1, ERG11 as well as HWP1, showed a significant change compared to controls. Conclusion. Monitoring of vaginal Candida colonization before the third trimester of pregnancy, that could reduce congenital Candida colonization and risk of pregnancy complications.

Antifungal Use and Resistance in a Lower–Middle-Income Country: The Case of Lebanon

“…In Lebanon, fluconazole resistance ranged from 2% to 33% in C. albicans , 22.2% to 100% in C. glabrata , and 16.4% to 95.7% in C. tropicalis . In Tunisia, resistance to fluconazole was observed in 63 % and 16% of C. albicans and C. glabrata isolates from vaginal swab samples of pregnant women, respectively [ 45 ]. Moreover, numerous sporadic cases and outbreaks caused by C. auris have been recently reported in the MENA region, including Lebanon [ 27 , 29 , 30 , 46 , 47 , 48 ].…”