Distribution and antifungal susceptibility profile of Candida species from vaginal swabs of outpatients

AIM: To show the distribution of Candida species in vaginal swabs of outpatients and antifungal susceptibility profile. BACKGROUND: Vulvovaginal candidosis (VVC) is a widespread health problem, present in pregnant women, women with diabetes, after antimicrobial therapy or related to any condition that alters the vaginal microbiota. Resistance of different Candida spp. to antifungal therapy has been reported as a public health problem. Antifungal resistance is a cause of treatment failure in patients and often results in recurrent infections. METHODS: The prospective pilot study was conducted from April to July 2024. Vaginal swabs collected from outpatients were analysed in the Microbiology laboratory, Institute for public health of Canton Sarajevo. Samples were cultured on Sabouraud dextrose agar at 37⁰C for 48h. Positive cultures were further tested with Integral System Yeast plus (Liofilchem) for Candida species identification and sensitivity evaluation to ten antimycotics, incubated at 37⁰C for additional 48h. RESULTS: A total of 85 culture positive vaginal swabs were further tested for identification and antifungal susceptibility, out of which 60% (n=51) were from pregnant women. The predominant species in all women was C. albicans with 75% (n=64), followed by C. parapsilosis 13% (n=11). C. albicans isolates were the most resistant to miconazole (10,9%) and clotrimazole (10,9%) and non-albicans to econazole (23,8%) and clotrimazole (23,8%). Resistance to fluconazole in C.albicans and non-albicans isolates was 3% and 9,5% respectively and to nystatin 7,8% and 14,3% respectively. CONCLUSION: The most common species isolated was C.albicans. Antifungal susceptibility should be tested in case of treatment failure.