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. 2018 Jun 15;18(1):94.
doi: 10.1186/s12905-018-0607-z.

Vulvovaginal candidiasis: species distribution of Candida and their antifungal susceptibility pattern

Adane Bitew  1 , Yeshiwork Abebaw  2
Affiliations

Vulvovaginal candidiasis: species distribution of Candida and their antifungal susceptibility pattern

Adane Bitew et al. BMC Womens Health. .

Abstract

Background: Vulvovaginal candidiasis is a global issue of concern due to its association with economic costs, sexually transmitted infections, and ascending genital tract infection. The aim of this study was to determine species distribution and antifungal susceptibility pattern of Candida species causing vulvovaginal candidiasis.

Methods: A cross sectional study was conducted from November 2015 to December 2016 at the Family Guidance Association of Ethiopia. Vaginal swabs collected from study subjects that were clinically diagnosed with vulvovaginal candidiasis were cultured. Yeast identification and antifungal susceptibility testing were determined by the automated VITEK 2 compact system. The association of vulvovaginal candidiasis with possible risk factors was assessed and analyzed using SPSS version 20.

Results: The overall prevalence of vulvovaginal candidiasis was 41.4%. The association of vulvovaginal candidiasis was statistically significant with previous genital tract infection (p = 0.004), number of life-time male sex partners (p = .037), and number of male sex partners in 12 month (p = 0.001). Of 87 Candida isolates recovered, 58.6% were C. albicans while 41.4% were non-albicans Candida species. The highest overall drug resistance rate of Candida species was observed against fluconazole (17.2%), followed by flycytosine (5.7%). All Candida isolates were 100% susceptible to voriconazole, caspofungin, and micafungin. C. albicans, was 100% susceptible to all drugs tested except fluconazole and flycytosine with a resistance rate of 2% each drug. C. krusei, was 100 and 33.3% resistant to fluconazole and flycytosine, respectively.

Conclusions: High prevalence rate of vulvovaginal candidiasis and observation of high prevalence rate of non-albicans Candida species in the present study substantiate, the importance of conducting continuous epidemiological surveys to measure changes in species distribution from C. albicans to non-albicans Candida species in Ethiopia. Although, fluconazole still appeared to be active against all isolates of C. albicans and non-albicans Candida species high resistance rate of C. krusei against the drug may demonstrate a search for alternative antifungal drugs when treating vulvovaginal candidiasis caused by C. krusei.

Keywords: Ethiopia; Non-albicans Candida species antifungal drugs; Vulvovaginal candidiasis.

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Conflict of interest statement

Authors’ information

YA, is a medical laboratory technologist with Msc degree in microbiology, she has been working as a medical laboratory technologist for Fitche Hospital for many years.

AB is an associate professor of microbiology and consultant health science specialist with a PhD degree. He has been working as a researcher and instructor offering courses to graduate students in the college of health sciences, Addis Ababa University for more than 24 years. He has published many original articles in peer-reviewed international journal.

Ethics approval and consent to participate

The study was conducted after it was ethically reviewed and approved by the Ethical Review board of the Department of Medical Laboratory Sciences (DRERC), School of Health Sciences, and Addis Ababa University. Written consents were also obtained from participants. Assent form was completed and signed by family member and/or adult guardian for participants under the age of 18 years.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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