Antifungal Susceptibility Pattern and Species Distribution of Candida Isolates from Patients with Vulvovaginal Candidiasis

The objectives of this study were to determine the prevalence of Candida in patients suffering from vaginitis, to assess predisposing factors, to identify Candida species and to determine the susceptibility profile of different Candida species to antifungal agents. This study was carried out in Sohag University Hospital during the period from August 2013 to August 2014. High vaginal swabs (HVS) were collected from 300 women with age range from (18-50 years) clinically diagnosed as vulvovaginitis. HVS were processed by wet mount microscopy, Gram stain, culture onto Sabouraud’s dextrose agar and CHROM agar plates. Isolates were identified and speciated using conventional methods, by the color of the colonies on the CHROM agar and by VITEK 2 System. Susceptibility testing to Clotrimazole, Miconazole, Fluconazole and Voriconazole by disc diffusion method was performed. Out of 300 HVS, Candida was isolated in 90 (30%) of cases. C.albicans was the predominant species isolated; 49 isolates (54.4%) followed by non albicans species like C. glabrata 22 (24.4%), C. tropicalis 13 (14.4%), C. famata 3 (3.3%), Candida dubliniensis1 (1.1%), C. Lusitania 1 (1.1%) and C. parapsilosis 1 (1.1%). Mixed infection with two species of Candida was seen in 5.6% of patients. The most common mixed cause was the combination of Candida albicans and Candida tropicalis (3.3%). Recurrent vulvovagintis has been the most frequently implicated risk factor (45.56%). Susceptibility tests revealed that; highest resistance was observed against Miconazole (14.3%) among the Candida albicans isolates and was observed against Clotrimazole (19.5%) among the non albicans isolates.