SPECIES DISTRIBUTION AND ANTIFUNGAL SUSCEPTIBILITY OF VAGINAL CANDIDA ISOLATES

Abstract

Introduction: Vulvovaginal candidiasis (VVC) is the most common Candida infection in females of reproductive age. Data concerning the species identification and antifungal susceptibility of vaginal Candida isolates are of great importance for the infection management. Aim: The aim of the present study was to determine the species distribution and antifungal susceptibility of Candida isolates obtained from vaginal samples of women with VVC. Material and methods: A total of 125 vaginal Candida isolates were collected and tested. The definitive species identification was performed by VITEC2 Compact (Bio Merieux, France) using YST ID cards. The minimum inhibitory concentrations (MICs) of nine antifungal agents were determined by the commercial system Micronaut-AM (Merlin Diagnostika GmbH, Germany). Results: Overall, 8 Candida species were established among the vaginal yeast isolates. The most common was C. albicans (77.6%), followed by C. glabrata (12%), C. krusei (4%), C. kefyr (2.4%), C. spherica (1.6%), C. lusitaniae, C. utilis, and C. sake (each one 0.8%). All C. albicans and 20 non-albicans Candida (NAC) were susceptible to nine antifungal agents. In the group of NAC, 8 isolates were resistant to fluconazole – 5 C. krusei with intrinsic resistance, 2 C. spherica, and 1 C. sake. The fluconazole MICs of C. spherica and C. sake were 32 - 128 μg/mL, and 16 μg/mL, respectively. Conclusions: C. albicans was the main causative agent of VVC. Among NAC, C. glabrata was the predominant species. In general, vaginal C. albicans and non-albicans Candida were susceptible to azoles as well as echinocandins, amphotericin B and 5-fluorocytosine. Of particular interest was the detection of rare non-albicans Candida isolates with acquired resistance to azoles.