Isolation of Different Species of Candida in Patients With Vulvovaginal Candidiasis From Sari, Iran

Abstract

Background:Vulvovaginal Candidiasis (VVC) is a frequent, complex and cumbersome condition that can cause physical and psychological distress for the involved individual. Candida albicans was reported as the most common agent of VVC yet it seems that we are recently encountering changes in the pattern of Candida species in VVC.Objectives:In this study we assessed different species of Candida isolated from patients with VVC, residing in Sari, Iran.Patients and Methods:Two hundred and thirty-four patients with vulvovaginitis were enrolled in this study. Samples were collected by a wet swab. Each vaginal swab was examined microscopically and processed for fungal culture. The identification of Candida species was done by morphological and physiological methods such as culture on CHROMagar Candida media and sugar assimilation test with the HiCandida identification kit (HiMedia, Mumbai, India).Results:Out of 234 patients with vulvovaginitis, 66 (28.2%) patients showed VVC. Of these patients, 16 (24.2%) had recurrent VVC (RVVC). The age group of 20 - 29 year-olds had the highest frequency of VVC (48.5%). Erythema concomitant with itching (40.9%) was the most prevalent sign in VVC patients. Fifty-seven (86.4%) of the collected samples had positive results from both microscopic examination and culture. In total, 73 colonies of Candida spp. were isolated from 66 patients with VVC. The most common identified species of Candida were C. albicans (42.5%), C. glabrata (21.9%) and C. dubliniensis (16.4%). In patients with RVVC and patients without recurrence, C. albicans and non-albicans species of Candida were frequent species, respectively.Conclusions:The results of our study showed that non-albicans species of Candida are more frequent than C. albicans in patients with VVC. This result is in line with some recent studies indicating that non-albicans species of Candida must be considered in gynecology clinics due to the reported azole resistance in these species.

Identification of Candida Species Isolated from Vulvovaginal Candidiasis Patients by Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) in Yasuj Southwestern Iran

“…The findings revealed that the prevalence of Candida vaginitis was 160 (51.6%). These results are similar to Mohamadi et al (17), Hedayati et al (15), and Rasti et al's studies (18). Furthermore, the present study indicated the high rate of VVC in 30-to 40-year-olds, which is in agreement with the study of Mohamadi et al (17), while it is in contrast with Rezaei-Matekolaei et al (19).…”

“…The PCR-RFLP was used to identify yeast isolated from patients with VVC. The frequency of VVC varied from 5.4% to 84% in reports from Iran and abroad (3,7,9,15,16). The findings revealed that the prevalence of Candida vaginitis was 160 (51.6%).…”

“…Also, Richter et al (22) reported that 24% of 593 symptomatic patients were non-albicans species in 1998 to 2001. Hedayati et al, using CHROM Candida agar medium for identification of two major Candida species and Hicandida kit for final differentiation of Candida species, showed non-albicans isolates of Candida, such as C. glabrata, C. dubliniensis, C. kefyr, and C. pintolopesii were more frequent than C. albicans (57.5% versus 42.5%) (15). However, non-albicans Candida species may cause more severe symptoms and are often more difficult to treat (22,23).…”

Molecular Epidemiology and In Vitro Antifungal Susceptibility of Candida Isolates from Women with Vulvovaginal Candidiasis in Northern Cities of Khuzestan Province, Iran

“…Vulvovaginal candidiasis is more prevalent in this age group probably due to the excessive use of contraceptive methods, such as intrauterine devices and oral contraceptive pills. In agreement with previous studies in Iran and other countries (2,24,25,(29)(30)(31), C. albicans was the most common pathogen isolated from VVC patients in the present study. However, in a study by Mohanty et al (32), C. glabrata was the main species isolated from VVC patients.…”

“…The infection was more prevalent in the age group of 20 -40 years, which is in agreement with the majority of previous studies performed in Iran (24)(25)(26)(27)(28). Vulvovaginal candidiasis is more prevalent in this age group probably due to the excessive use of contraceptive methods, such as intrauterine devices and oral contraceptive pills.…”