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Background and Purpose:Annually affecting millions of women, vulvovaginal candidiasis (VVC) is commonly described by signs and symptoms of vulvovaginal inflammation in the presence of Candida species. Today, the detection of the virulence factors plays a major role in the understanding of pathogenesis of candidiasis and helps produce new anticandidial drugs to improve its treatment efficiency. Herein, we aimed to evaluate the esterase and hemolysin activities of the vaginal isolates of Candida and their relationship with the presence of VVC.Materials and Methods:One-hundred vaginal clinical specimens were randomly collected during September-December 2016. The target population consisted of married women suspected of VVC who presented to health centers in Lorestan Province, Iran. In this study, the esterase activity and hemolysin production of Candida clinical isolates were evaluated using the Tween 80 opacity test and the plate assay, respectively.Results:The most frequent Candida species was C. albicans (66; 66%), followed by C. glabrata (11; 11%) and C. tropicalis (11; 11%). The highest esterase activity was found in C. krusei (75%), followed by C. albicans (68.2%) and C. glabrata (54.5%). The greater part of the positive esterase isolates had Pz 4+ scores. Among the Candida species, C. albicans (22.7%), C. glabrata (63.6%), and C. krusei (50%) were found to have the highest rates of alpha, beta, and gamma hemolysin production, respectively. The level of hemolytic activity in 51% of the Candida species was Pz 4+ scores.Conclusion:According to our results, the higher expression rates of both enzymes in C. albicans species relative to those of non-albicans Candidate species can partly reflect the role of the virulence factors involved in C. albicans pathogenicity.

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Background and Objective: The prevalence of the infections caused by Candida species has led to a significant increase in their resistance to antifungal compounds. The aim of this study was to i) investigate drug resistance ii) evaluate the incidence of Candida albicans drug resistance pattern in the vaginal samples of women referring to health centers of Qom province, and iii) examine the effect of Zn nanoparticles combined with fluconazole against C. albicans isolates. Methods: This experimental, descriptive study was performed on 120 patients of candidiasis. In order to identify Candida albicans, direct experiments, differential culture, Germ tube test and sugar assimilation test (API20C kit) were conducted. The effect of different antifungal drugs and zinc nanoparticles and the synergistic effect of fluconazole with zinc nanoparticles were investigated by disk diffusion method. Minimum Inhibitory Concentration (MICs) of all cases was further specified. Results: Of the 120 samples, 50 (41.6%) were identified as Candida albicans. These strains were resistant to certain antifungal drugs while others were semi-sensitive and sensitive. The lowest and the highest mean diameter of inhibition zone in all Candida albicans isolates belonged to ketoconazole (15.64 mm) and fluconazole nano-ZnO (26.76mm), respectively. The lowest and the highest MICs were observed in fluconazole-nano-ZnO and nano-ZnO, respectively. Conclusion: The synergistic effect of Zn nanoparticles with fluconazole can be conducive to the treatment of vaginal candidiasis.