Prevalence, susceptibility profile and proteinase production of yeasts causing vulvovaginitis in Turkish women

Abstract

In this study the prevalence of vulvovaginal candidiasis (VVC), antifungal susceptibility and proteinase production of isolated Candida species were investigated. Vaginal swabs were collected from symptomatic women with vulvovaginitis attending the Obstetrics and Gynecology Clinic of Kocaeli University, Turkey. The relation between risk factors, such as pregnancy, diabetes mellitus, antibiotic and corticosteroid use, history of sexually transmitted diseases and contraceptive methods, was recorded. Candida spp. were identified by conventional methods, then evaluated for proteinase secretion in a medium containing casein. Antifungal susceptibility was determined according to the NCCLS microdilution method. The prevalence of women with vulvovaginitis was 35.7% (170/6080) and 16% (28/170) of them were diagnosed as VVC. Candida albicans was the dominant species: 21 (75%), followed by 4 C. glabrata (14%), 2 C. tropicalis (7%), and one C. krusei (3.5%). All isolates were susceptible to fluconazole, itraconazole and amphotericin B, except one C. krusei, one C. glabrata and one C. albicans that were resistant to fluconazole. Proteinase production was determined in 19 (90.5%) C. albicans and in all C. tropicalis isolates. Proteinase activity was not associated with antifungal resistance. No association was found between risk factors and VVC.

A Challenge for Clinical Laboratories: Detection of Antifungal Resistance inCandidaSpecies Causing Vulvovaginal Candidiasis

“…5 The rates of resistance observed in this study suggest the vaginal yeasts behave similarly to the yeasts causing systemic infections, 14,28 an observation that diverges from previous reports about VVC. 7,8,11 The susceptibility profiles of vaginal yeasts have been changing.…”

Issues in Identifying Germ Tube Positive Yeasts by Conventional Methods

“…Despite the fact that C. albicans remains the main species of yeast isolated from vaginal specimens over the past few years, other non‐albicans species have also been isolated . Vaginal colonization of Candida species can be influenced by many factors, one of which is pregnancy.…”

Molecular diagnosis of vaginal candidiasis by polymerase chain reaction (PCR) and random amplification polymorphism DNA (RAPD-PCR) in Babylon Province, Iraq

“…) showed that Candida albicans is responsible for 70-90% of all vaginal candidiasis in Austria while many other studies showed that Candida glabrata has been the most frequent pathogen that causes vaginal Candidiasis (Novikova et al, 2002;Lopes Consolaro et al, 2004). Ozcan et al (2006) reported that C. glabrata is responsible for 14% of infections in immune competent women. Candida is a member of normal flora in vagina and oral cavity; however, there are many predisposing factors that can lead to these infections such as pregnancy, long term use of antibiotics, diabetes mellitus, using of corticosteroids, HIV infection, and being immunocompromised (Fidel and Sobel, 1996;Duerr et al, 1997Duerr et al, , 2003Corsello et al, 2003;Beltramene et al, 2006).…”