Prevalence, Risk Factors and Antifungal Susceptibility of Vulvovaginal Candadiasis among Saudi Females

Abstract

Background: Vulvovaginal candidiasis (VVC), is the most common fungal disease in normal healthy women. Understanding of the antifungal susceptibility patterns of pathogenic fungi is essential as resistance of some vaginal yeasts isolates to antifungal agents has been reported. Objectives: to determine the prevalence of VVC, associated risk factors and evaluate antifungal susceptibility and species (spp.) distribution in Saudi patients. Methodology: High vaginal swabs were collected from all patients suffering from vaginitis. Different Candida spp. were identified by Gram stain, germ tube test, growth on CHROM agar and API 20C AUX. Antifungal susceptibility test was done by disk diffusion method. Results: VVC represented 23.5%. Out of these patients 11% had recurrent vulvovaginal candidiasis (RVVC). C. albicans represented 82% whereas non albicans spp. represented 18%. In RVVC C. albicans represented 43% and non albicans spp. represented 57%. VVC was significantly presented with pruritus and associated with pregnancy, diabetes and age group from 30 to 39 year. RVVC was significantly presented with dysuria and/ or dysparonia. All isolates were sensitive to amphotericin B, while 94% were sensitive to nystatin. Over all sensitivity to fluconazole, voriconazole, ketoconazole and miconazole was 79.5%, 86%, 96.5% and 83% respectively. Conclusion: VVC prevalence represented 23.5% whereas RVVC was 11%.C. albicans is associated with VVC, whereas non albicans spp are associated with RVVC. Diabetes, pregnancy and age group (30 – 39) are considered as potential risk factors for VVC whereas antibiotics and contraceptive pills are not. Nystatin, amphotericin B and ketoconazole have the best antifungal activity against all spp.