Prevalence, species distribution and antifungal susceptibility of Candida albicans causing vaginal discharge among symptomatic non-pregnant women of reproductive age at a tertiary care hospital, Vietnam

Abstract

Background Vaginal candidiasis is frequent in women of reproductive age. Accurate identification Candida provides helpful information for successful therapy and epidemiology study; however, there are very limited data from the Vietnam have been reported. This study was performed to determine the prevalence, species distribution of yeast causing vaginal discharge and antifungal susceptibility patterns of Candida albicans among symptomatic non-pregnant women of reproductive age. Methods Vaginal discharge samples were collected from 462 women of reproductive age in Hanoi, Vietnam between Sep 2019 and Oct 2020. Vaginal swabs from these patients were examined by direct microscopic examination (10% KOH). CHROMagar™ Candida medium and Sabouraud dextrose agar supplemented with chloramphenicol (0.5 g/l) were used to isolate yeast, and species identification was performed using morphological tests and molecular tools (PCR and sequencing). Antifungal susceptibility testing was determined according to the Clinical and Laboratory Standards Institute guidelines (M27-A3 and M27-S4). Results The prevalence of vaginal yeast colonization in non-pregnant women was 51.3% of 462 participants. Nine different yeast species were identified. Among these isolates, C. albicans (51.37%) was the most frequent, followed by C. parapsilosis (25.88%), C. glabrata (11.37%), C. tropicalis (4.31%), C. krusei (3.92%), C. africana (1.57%), Saccharomyces cerevisiae (0.78%), C. nivariensis (1 isolates, 0.39%), and C. lusitaniae (1 isolates, 0.39%), respectively. Among C. albicans, all 46 isolates were 100% susceptible to micafungin, caspofungin, and miconazole. The susceptibility rates to amphotericine B, 5-flucytosine, fluconazole, itraconazole and voriconazole were 95.65, 91.30, 91.30, 82.61 and 86.95%, respectively. Conclusions The prevalence of VVC among symptomatic non-pregnant women of reproductive age in Vietnam was higher than many parts of the world. The high frequency of non-albicans Candida species, which were often more resistant to antifungal agents, was a notable feature. Resistance rates of vaginal C. albicans isolates to antifungal agents was low. Our findings suggest that continued surveillance of changes in species distribution and susceptibility to antifungals should be routinely screened and treated.

Loop-mediated isothermal amplification: A rapid and simple method for detection of fluconazole resistant Candida albicans vaginitis

“…Results of the present study concluded that the percent of vaginal Candida infection was 46.8 % of all participants in the study and the most frequent Candida isolate was C. albicans (48.72% of total positive samples). These results are matched with Anh et al [11] study who declared that vaginal yeast colonization in non-pregnant women was 51.3% of participants and C. albicans was the most frequent (51.37%). As Taei et al [12] study declared that the increasing of non-albicans Candida (NAC) species have been recognized significantly during the last two decades, results of the present study showed that the NAC represented 51.28% of total positive samples.…”

Anti-Biofilm Activity of Phenyllactic Acid against Clinical Isolates of Fluconazole-Resistant Candida albicans

“…Candida albicans , which is part of normal vaginal microflora and becomes a robust opportunistic fungal pathogen under various conditions, has been considered the major causes of vulvovaginitis, the medical impact of which also depending on the strain ability to form biofilms [ 4 ]. Regarding treatment, intravaginal and oral azole drugs are currently prescribed for the treatment of VVC and Fluconazole, which is the drug of choice led to the acquisition of inherent resistance, in about 30% of vaginal positive cultures, consequently resulting in failure of therapeutic treatment of the infection [ 5 , 6 ]. Biofilms are communities of microorganisms embedded in an exopolysaccharide matrix that attach to surfaces.…”

Novel Graphene Oxide/Quercetin and Graphene Oxide/Juglone Nanostructured Platforms as Effective Drug Delivery Systems with Biomedical Applications

“…Therefore, novel solutions and compounds need to be utilized in order to keep up with the evolution of bacterial resistance mechanisms. A prevalence of S. aureus, E. coli, and C. albicans infections associated with the biomedical field has been reported by several authors [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ].…”