Study of Vulvo-vaginal candidiasis and in vitro anti-fungal susceptibility pattern

Vulvovaginal Candidiasis (VVC) mostly affects women of childbearing age and it is the second most common form of vaginitis. The range of VVC manifestations may be from asymptomatic colonization to severe acute symptomatic infection. 10%-20% women with VVC have asymptomatic colonization with Candida species. The aim of the study was to identify the species of Candida causing Vulvo- vaginal candidiasis(VVC) in the study population & perform the anti fungal susceptibility of the fungal isolates.Two High Vaginal Swabs were collected from suspected cases. Wet mount, culture on Sabouraud’s dextrose agar (SDA) and Blood agar were done for identification of Candida infection. Isolates from the culture plates were inoculated on HiCrome differential candida agar for speciation. All isolates were tested for antifungal susceptibility to Voriconazole, Ketoconazole, Fluconazole, Amphotericin, Nystatin and Itraconazole using Disk Diffusion method. Out of the 28, 9 cases (32.14%) were positive for Candida species of which 4(44.4%) were candida albicans.Nonalbicans Candida(NAC) were 5(55.5%) of which 2(22.22%) were C. tropicalis, 1 (11.11%)was C. glabrata and 2(22.22%) were combination of C. glabrata and C. tropicalis mixed infection. Candida albicans was the most isolated species. C. albicans isolates were 100% sensitive to all antifungals under study. C. tropicalis was sensitive to antifungals under study with a range of 25% to 75% . While C. glabrata isolates were sensitive to Voriconazole, Fluconazole, Itraconazole and Ketoconazole they were resistant to Nystatin and Amphotericin. NAC species were mostly resistant to antifungals. With decreasing susceptibility to Ketoconazole, the use of azoles should be shifted to Voriconazole, Fluconazole and Itraconazole.