Prevalence and antifungal susceptibility of Candida albicans causing vaginal discharge among pregnant women in Lebanon

Abstract

Background Vaginal candidiasis is frequent in pregnant women and is associated with sepsis and adverse neonatal outcomes. This study determined the prevalence of candida species in symptomatic pregnant women and evaluated the antifungal susceptibility profile of the isolated Candida strains. It also aimed to explore whether Candida species predicts gestational complications and adverse neonatal outcomes. Methods A total of 258 pregnant women with vaginal discharge at 35 to 37 week of gestation participated in this study. Vaginal swabs from these patients were collected at various obstetrics and gynecology clinics in Lebanon for a period of 14 months. Candida isolates were identified at species level and antifungal susceptibility of Candida albicans to fluconazole (FCZ), amphotericin B (AMB), itraconazole (ICZ) and voriconazole (VCZ) was determined by the agar-based E-test method. Results Among 258 women tested, 100 (39%) were positive for Candida species. C. albicans, C. glabrata and C. krusei were isolated from 42, 41 and 17% of the women, respectively. C. albicans was significantly associated only with gestational diabetes while C. krusei or C. glabrata had significant positive associations with other gestational complications. The antifungal susceptibility tests of C. albicans isolates revealed 97.5, 90, 87.5 and 97.5% susceptibility to AMB, FCZ, ICZ and VCZ, respectively. Conclusion The current study revealed high incidence of both C. albicans and non-C. albicans Candida strains causing vulvovaginitis among pregnant women in Beirut, Lebanon. Candida screening as antenatal follow up is advised to minimize the risk of adverse neonatal outcome or gestational complications.

Analysis of Biofilm-Related Genes and Antifungal Susceptibility Pattern of Vaginal Candida albicans and Non-Candida albicans Species

“…In addition, Ghaddar et al revealed that 97.5% of C . albicans isolates from VVC patients were resistant to VRC [ 37 ]. Our findings demonstrated that 23.4% and 10.6% of C .…”

Whole genome sequencing of a clinical drug resistant Candida albicans isolate reveals known and novel mutations in genes involved in resistance acquisition mechanisms

“…Consequently, C. albicans infections pose a serious public health threat worldwide including Lebanon. To date only a handful of studies have addressed resistance of Lebanese C. albicans isolates to azoles, echinocandins, and polyenes [11–17] but none of the studies have looked at the entire genome of C. albicans to generate a complete picture of the genomic aspects of antifungal resistance.…”

Phytochemical analysis and antifungal property of Mallotus oppositifolius (Geiseler) Müll.Arg. (Euphorbiaceae)

“…Invasive candidiasis for instance is estimated to affect more than 250 million people causing more than 50,000 deaths worldwide every year. Epidemiological data unveils an incidence of 2 to 14 cases of candidemia per 100,000 individuals with a mortality range of 10 to 20% (Ghazi et al, 2019).Such infections occur as opportunistic consequences of other health problems including surgical operations, asthma, malnutrition, AIDS, cancer, alcoholism, organ transplantation, diabetes, corticosteroid therapies and the widespread drug resistance (Nowak and Szyfter, 2008;Tudela and Denning, 2017;Bongomin et al, 2017;Ghaddar et al, 2020).…”