DOI: http://dx.doi.org/10.18203/2349-3933.ijam20200076

Identification of various Candida species isolated from patients with vulvovaginal candidiasis attending a tertiary care hospital in North India

Noor Jahan, Pratishtha Vishnoi, Bhavana Gupta, Swati Srivastava, Siraj Ahmad, Razia Khatoon

Abstract


Background: Vulvovaginal Candidiasis (VVC) is a condition diagnosed in a large proportion of women presenting with complaints of abnormal vaginal discharge. The risk of VVC is high in women with diabetes mellitus, pregnancy, using oral contraceptives or broad-spectrum antibiotics and those having Human Immunodeficiency Virus infection.

Objective of the present study was to identify the various species of Candida isolated from patients with Vulvovaginal Candidiasis.

Methods: A cross-sectional study was done from January to June 2018. A total of 69 clinically suspected VVC cases were included in the study whose high vaginal swabs were collected and subjected to direct microscopy and cultured on Sabouraud Dextrose Agar (SDA). Creamy white pigmented colonies on SDA were confirmed as Candida by doing Gram’s staining. Speciation of positive cultures was confirmed by conventional methods like Corn Meal agar culture, Germ tube test (GTT), Candida CHROM Agar Medium (CAM), sugar assimilation and fermentation test.

Results: Out of 69 clinically suspected VVC cases included in the study, only 14 cultures were positive for Candida species. All the 14 isolates were found to be Non-albicans Candida (NAC). Most common species isolated were Candida glabrata 7(50%), followed by Candida tropicalis 3(21.4%), Candida lusitaniae 3(21.4%), and Candida parapsilosis 1 (7.1%).

Conclusions: Candida albicans was known to be the most common causative agent of VVC as it was isolated in 90% cases. However, this study showed that all isolates from VVC were Non-albicans Candida. Therefore, species identification should be done in all microbiology laboratories for accurate diagnosis of VVC.


Keywords


Candida CHROM agar medium, Corn meal agar, Non-albicans candida, Vulvovaginal candidiasis

Full Text:

PDF

References


Achkar JM, Fries BC. Candida infections of the genitourinary tract. Clin Microbiol. 2010;23:253-73.

Lopez-Martinez R. Candidosis, a new challenge. Clin Dermatol. 2010;28:178-84.

Kalaiarasan K, Singh R, Chaturvedula L. Fungal profile of Vulvovaginal Candidiasis in a tertiary care hospital. J Clin Diagnos Res. 2017;11:06-9.

Bonyadpour B, Akbarzadeh M, Mohagheghzadeh A. A descriptive study on the prevalence of Vulvovaginal infections and species-specific distribution of Vulvovaginal Candidiasis in married women of the South of Iran. J Midwifery Reproduct Health. 2016;4:741-7.

Sobel JD. Candida vulvovaginitis: Clinical manifestations and diagnosis. UpToDate. 2018:1-23.

Swaminathan KR, Devi M, Gerald S, Prakesh SC, Thomas BM. Prevalence of vulvovaginal candidiasis in the women of the reproductive age, in rural India. Intern J Clin Obstetr Gynaecol. 2017;1:37-9.

Al-mamari A, Al-buryhi A, Al-heggami MA, Al-hag S. Identify and sensitivity to antifungal drugs of Candida species causing vaginitis isolated from vulvovaginal infected patients in Sana’a city. Der Pharma Chem. 2014;6:336-42.

Ghosh A. Standard Operating Procedures National Antifungal Resistance Surveillance. ICMR Nodal Center. 2015:2-36.

Dermendzhiev T, Hadzhieva K, Dermendzhiev S, Murdjeva M. Analysis of clinical and microbiological indicators of vulvovaginal candidiasis. Biotechnol Equipment. 2016;30:1173-8.

Samal R, Vaithy A, Kotasthane DS, Ghose S. Prevalence and clinic-mycological profile of vulvovaginal candidiasis in a tertiary care hospital. Intern J Reproduct Contracep Obstetr Gynecol. 2015;4:1-6.

Mahmoudabadi AZ, Zarrin M, Miry S. Phospholipase activity of Candida albicans isolated from vagina and urine samples. Jundishapur J Microbiol. 2010;3:169-73.

Bang RA, Bang AT, Baitule M, Choudhary Y, Sarmukaddam S, Tale O. High prevalence of gynaecological diseases in rural Indian women. Lancet. 1989;1:85-8.

Prasad JH, Abraham S, Kurz KM, George V, Lalitha MK, John R, et al. Reproductive tract infections among young married women in Tamil Nadu, India. Intern Family Planning Perspectives. 2005;31:73-82.

Woike P, Gaur R, Jain B. Vaginal Candidiasis- the known opportunistic fiend in developing countries. IOSR J Dental Med Sci. 2018;17:18-21.

Kalia N, Singh J, Sharma S, Kamboj SS, Arora H, Kaur M. Prevalence of Vulvovaginal infections and species-specific distribution of Vulvovaginal Candidiasis in married women of North India. Intern J Current Microbiol Appl Sci. 2015;4:253-66.