Abstract

BackgroundAccurate identification Candida is important for successful therapy and epidemiology study. The aim of research is to study API 20C yeast identification system identification rate by using molecular identification as gold standard and tested the antifungal susceptibility of Candida from patients with vulvovaginal candidiasis (VVC).MethodsIn total, 3574 yeast isolates were obtained from patients with VVC. API 20C yeast identification, molecular identification and in vitro antifungal susceptibility were performed.ResultsC. albicans was the predominant Candida species [2748 isolates, 76.9%] in VVC. The isolates from vaginal samples represented 22 species based on molecular identification. The API 20C system identifies only 11 of the species encountered during the study period. Based on the API 20C system, 3273 (91.58%) isolates were correctly identified to the species level. The correct identification rate of the API 20C system for rare yeast was 15.29% (26/170 isolates). Antifungal susceptibility was tested in a total of 1844 isolates of Candida from patients with VVC. C. albicans was susceptible to most of the tested antifungals. The MICs of azoles for C. glabrata were higher than those for C. albicans. The MICs of echinocandins for C. parapsilosis were higher than those for C. albicans.ConclusionsThe API 20C yeast identification system can be used to reliably identify the most common Candida species while molecular methods are necessary for the identification of closely related, emerging, and rare yeast species. The results from this study suggest that much of the previous studies on the epidemiology of VVC should be re-thought. C. albicans was susceptible to most of the tested antifungals.

Highlights

  • Accurate identification Candida is important for successful therapy and epidemiology study

  • We reported the distribution of yeast isolates based on molecular identification from patients with Vulvovaginal candidiasis (VVC) in southern China from 2003 to 2018 and compare the identification rate of molecular methods with API 20 C system

  • By using molecular identification, we found that C. albicans was still the most common Candida species in VVC, followed by C. glabrata, C. parapsilosis and C. tropicalis

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Summary

Introduction

Accurate identification Candida is important for successful therapy and epidemiology study. The aim of research is to study API 20C yeast identification system identification rate by using molecular identification as gold standard and tested the antifungal susceptibility of Candida from patients with vulvovaginal candidiasis (VVC). An estimated 75% of women will have at least one episode of vulvovaginal candidiasis (VVC) and 40–45% will have two or more episodes [1]. Treatment options for refractory symptoms caused by antifungal resistant Candida are extremely limited. Options and strategies are urgently needed to meet the challenge of drug resistance [10,11,12,13,14,15]. We reported the distribution of yeast isolates based on molecular identification from patients with VVC in southern China from 2003 to 2018 and compare the identification rate of molecular methods with API 20 C system. We tested the common used and several potential clinical using antifungals

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