Susceptibility Pattern of Various Azoles Against Candida Species Causing Vulvovaginal Candidiasis

Dharmik, Preeti G.; Gomashe, Ashok V.; Upadhyay, V. G.

doi:10.1007/s13224-012-0280-3

Cited by 23 publications

(16 citation statements)

References 14 publications

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“…Figure 1 summarizes the distribution of Candida species isolated from vaginal swabs from population-based studies conducted in different countries including our study over the last decade. China, Brazil, Tunis, Kuwait, India, Greece and Turkey have reported that C.albicans remains the most commonly isolated yeast (60%-80%) in women diagnosed with VVC [21][22][23][24][25][26][27]. On the other hand, an increasing trend in the occurrence of NCAC (58%-60%) over time has also been observed in Pakistan and Burkina Faso [28,29].…”

Section: Resultsmentioning

confidence: 98%

Prevalence and Antifungal Susceptibility of Candida albicans Causing Vaginal discharge Among Pregnant Women in Lebanon

Ghaddar

Anastasiadis

Halimeh

et al. 2019

Preprint

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Background: Vaginal candidiasis is frequently prevalent in pregnant women and is associated with sepsis and adverse neonatal outcomes. This study determined the presence of Candida species in symptomatic pregnant women and evaluated the antifungal susceptibility profile of the isolated strains. It also aimed to explore whether Candida species predicts gestational complications and adverse neonatal outcomes. Methods: A total of 258 pregnant women 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 12 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 had significant positive associations with gestational diabetes while C. kreusi or C. glabrata had significant positive associations with gestational complications and vaginal discharge. 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 strains causing vulvovaginitis among pregnant women in Beirut, Lebanon. Whereas the susceptibility rates of C. albicans against AMB and VCZ were high, FCZ and ICZ proved comparatively less efficacious. The resistance profile of circulating C. albicans among pregnant women can predict the best outcome of appropriate prophylaxis or treatment of neonatal candidiasis. Vaginal candida colonization might lead to adverse neonatal outcome or gestational complications thus Candida screening as antennal follow up is advised.

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Section: Resultsmentioning

confidence: 98%

Prevalence and Antifungal Susceptibility of Candida albicans Causing Vaginal discharge Among Pregnant Women in Lebanon

Ghaddar

Anastasiadis

Halimeh

et al. 2019

Preprint

View full text Add to dashboard Cite

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“…identified in women with VVC and depends largely on the location as well as the population studied (Figure 1). Recent studies from countries such as China, Brazil, Tunis, Kuwait, India and Turkey have reported that C. albicans remains the most commonly isolated yeast (60%-80%) in women diagnosed with VVC [38][39][40][41][42][43]. On the other hand, an increasing trend in the occurrence of NCAS (58%-60%) over time has also been observed in Pakistan and Burkina Faso [31,44].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Antifungal Susceptibility of Candida albicans Causing Vulvovaginitis Among Pregnant Women in Lebanon

Ghaddar¹,

Anastasiadis²,

Halimeh³

et al. 2019

Preprint

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Background: Vaginal candidiasis is frequently prevalent in pregnant women and is associated with sepsis and adverse neonatal outcomes. This study determined the presence of Candida species in symptomatic pregnant women and evaluated the antifungal susceptibility profile of the isolated strains. It also aimed to explore whether Candida species predicts gestational complications and adverse neonatal outcomes. Methods: A total of 258 pregnant women 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 12 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 had significant positive associations with gestational diabetes while C. kreusi or C. glabrata had significant positive associations with gestational complications and vaginal discharge. 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 strains causing vulvovaginitis among pregnant women in Beirut, Lebanon. Whereas the susceptibility rates of C. albicans against AMB and VCZ were high, FCZ and ICZ proved comparatively less efficacious. The resistance profile of circulating C. albicans among pregnant women can predict the best outcome of appropriate prophylaxis or treatment of neonatal candidiasis. Vaginal candida colonization might lead to adverse neonatal outcome or gestational complications thus Candida screening as antennal follow up is advised.

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“…Azoles are fungistatic, thus inhibiting the growth of fungi leading to a clearance of the infection. Most C. albicans strains are susceptible to available antimycotic drugs and real resistance of isolates is rare [42][43][44][45]. Topical azole agents are available in a variety of formulations and are often sold over the counter for self-treatment.…”

Section: Candida Albicansmentioning

confidence: 99%

Expression of Psoriasin in Human Papillomavirus–Induced Cervical High-Grade Squamous Intraepithelial Lesions

Alvendal

Kamolvit

Wagner

et al. 2019

J Low Genit Tract Dis

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Background: Infections of the female genital tract are common and have severe impact on the quality of life and sexual health of affected women. The innate immune system is crucial and is involved in the defense of infections. Understanding innate immunity of the vaginal and cervical mucosa is important to enable development of future preventive and therapeutic strategies for genital infections. Objective: The aim of this thesis was to investigate innate immune factors in women with recurrent candida vulvovaginitis (RVVC) and high grade squamous intraepithelial lesions (HSIL) of the cervix, induced by human papilloma virus (HPV). This in order to contribute to the understanding of the innate immune response in these two common infections of the lower female genital tract. Material and Methods: Clinical examinations, measurements of intravaginal nitric oxide (NO) levels and vaginal biopsies were performed in 28 patients with RVVC and 31 healthy controls. Cervical biopsies and vaginal lavage were collected from 19 patients with HPV induced HSIL and 14 controls. Immunohistochemistry (IHC), enzyme-linked immunosorbent assay (ELISA), western blot and reverse transcriptase real time polymerase chain reaction (PCR)) were used to identify and quantify inducible nitric oxide synthase (iNOS), antimicrobial proteins, cytokines and encoding genes. Adhesion and binding assays were performed to evaluate the adhesive capacity of candida and to demonstrate the binding between candida and the antimicrobial protein psoriasin. Transmission electron microscopy was conducted to measure the cell wall thickness in C. albicans affected by psoriasin. To evaluate a new treatment strategy for RVVC, the effect of chlorhexidine digluconate and fluconazole on C. albicans eradication and biofilm was investigated in RVVC and commensal strains, using the crystal violet method and viable count. Results: NO levels were significantly higher in patients during acute infection compared to controls. Levels decreased after fluconazole treatment but remained higher than in controls. Furthermore, increased expression of iNOS was observed in the epithelial basal layer in patients both before and after treatment. There were positive correlations between NO levels, clinical symptoms and examination scores. Findings indicated that C. albicans induces production of psoriasin during mucosal candida infection. Psoriasin was shown to interact with β-glucan in the candida cell wall and inhibit candida adhesion to surfaces. In HPV induced HSIL, psoriasin expression and protein levels increased significantly after surgical treatment and reached similar levels as in controls. The mRNA expression of the proinflammatory cytokine IL-8 was higher before treatment and restored to the same levels as in controls six months after lesions were excised. Chlorhexidine digluconate prevented new biofilm formation and reduced already established C. albicans biofilm. Moreover, the number of candida cells in both planktonic state and within the biofilm were significantly decreased....

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Susceptibility Pattern of Various Azoles Against Candida Species Causing Vulvovaginal Candidiasis

Abstract: In the current study, prevalence rate of VVC was found to be 18.4 %, and among the various azoles tested, fluconazole has the highest antimicrobial activity.

Cited by 23 publications

References 14 publications

Prevalence and Antifungal Susceptibility of Candida albicans Causing Vaginal discharge Among Pregnant Women in Lebanon

Prevalence and Antifungal Susceptibility of Candida albicans Causing Vaginal discharge Among Pregnant Women in Lebanon

Prevalence and Antifungal Susceptibility of Candida albicans Causing Vulvovaginitis Among Pregnant Women in Lebanon

Expression of Psoriasin in Human Papillomavirus–Induced Cervical High-Grade Squamous Intraepithelial Lesions

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