Clinical and Mycological Study of Vulvovaginal Candidiasis (VVC); Identification of Clinical Isolates by Polymerase Chain Reaction-Fragment Size Polymorphyim (PCR-FSP) Technique

Abstract

Background: Vulvovaginal candidiasis is a widespread and frequent infection affecting up to 70% of healthy women, and some of them affected by recurring resistant forms of the disease. The main risk factors are hormone replacement therapy, diabetes mellitus, antibiotic usage, pregnancy, oral-contraceptives, and insufficient therapy. Candida albicans is the most etiologic agent of Candida vaginitis capable of colonizing on the mucous membrane of genitourinary tracts of healthy humans. The aim of the present study is to identify Candida species obtained from patients with vulvovaginitis by molecular techniques. Methods: Between 2015 - 2016, 108 suspected patients were evaluated for vulvovaginal candidiasis. Suspected patients were divided into 3 groups and each group took only 1 antifungal agent including clotrimazole, miconazole, and nystatin, respectively. Direct microscopic examination, culture, and fragment size polymorphism (FSP) technique were used for identification of clinical isolates Results: Of the 108 patients, 59 (54.6%) had both positive culture and direct microscopic examination. The duration of disease was between 3 to 365 days. Candida albicans was the most prevalent Candida species isolated from patients (74.5%) followed by Candida glabrata (17%). The correlation between the kind of antifungal agents and recovery of patients was not statistically significant (P value = 0.056). Conclusions: Resistance to various antifungal agents and emerging of non-albicans Candida species among clinical specimens are crucial affairs in the field of medical mycology. Since VVC is a prevalent and recurrent infection, controlling of predisposing factors, personal hygiene, and appropriate antifungal therapy are extremely recommended among vulnerable population.