Abstract
Background: Vulvovaginal candidiasis(VVC), or Vaginal thrush, is a vaginitis caused by the overgrowth of some opportunistic yeasts of the genus Candida spp. Australian Tea Tree Oil (TTO) is one of the most important essential oils that contain many compounds that are effective against many bacteria and fungi, which may match the effect of common antibiotics.
 Objective: The aim of this study was to isolate and diagnose fungi that causing vaginal thrush, in pregnant women and to study the effect of (pregnancy and pregnancy sequence and age) on the rate of infection compared to non-pregnant, as well as to study the drug sensitivity of isolates towards a number of antifungal and compared that with the inhibitory effectiveness of tea tree oil.
 Material and Methods: 75 vaginal swabs from pregnant women and 50 from non-pregnant women were collected at ages ranging from 17-65 years. The isolates were diagnosed using several methods, including the Vitek2 Compact system. 17 isolates were selected to study the inhibitory effect of ten antifungal agents, six of them were automatically tested by the Vitek 2 compact system, which contains a sensitivity test kit (AST-YS07 Card). The essential oil (TTO) was analyzed by GC-MS to detect its content of active compounds. The inhibitory effect of TTO was studied according to "Broth dilution" method to determine minimum inhibitory concentration (MIC) for it, the inhibitory effect of four concentrations of TTO (100%, 50%, 25%, 12.5 %) was also tested according to "well diffusion" method. This investigation also included a study of the mechanism of action (TTO).
 RESULTS: The rate of infection among pregnant women was (41%) with the highest rate of infection during the third trimester of pregnancy, while the percentage of non-pregnant women was only 8%. Vaginal infection was also prevalent in the age group ranged between (17-29 years).The isolates showed resistance to (Ketoconazol, Terbinafine) while they were sensitive to (Nystatin, clotrimazol), as well as sensitive to all antifungal of (AST-YS07 Card). The analysis of the TTO using chromatogram showed that it contains 32 chemical compounds, most of them are monoterpene like (Terpinen-4-ol, 1, 8-Cineol). The MIC of TTO ranged between (4 - < 2 µl/ ml). The function of TTO is to destroy the structural structure of the cell membrane and change its permeability, thereby leakage of cellular components and cell death. 
 Conclusion: Pregnancy increases the rate of vaginal candidiasis in women, especially during the third trimester. TTO is highly effective in inhibiting the growth of opportunistic candida yeasts.
 
Highlights
Vulvovaginal candidias (VVC) or vaginal thrush is vaginitis is caused by the overgrowth of some opportunistic yeasts of the genus Candida spp due to local or systemic factors
C. albicans is the most common opportunistic colonizer of the vagina, responsible for most cases of (VVC) and is part of the normal flora of the human body, colonizing various anatomical sites such as the oral cavity, skin and vagina, in about 50% of a healthy member of the community without causing any health problems, but its presence is necessary for the host because it limits the spread of pathogenic fungi and enhances the immune system functions]5,6[
Many studies have shown that the incidence of vaginal candidiasis (VC) increases in women with pregnancy, especially during the last third, and this increase may be due to several reasons, the most important, change the pH of the vagina, increase the proportion of sugar in the vaginal secretions, and increase the level of estrogen During pregnancy it produces more glycogen in the vagina, which provides a good source of carbon necessary for the growth of Candida and germination, which leads to faster growth of yeast ]7,8,9[
Summary
Vulvovaginal candidias (VVC) or vaginal thrush is vaginitis is caused by the overgrowth of some opportunistic yeasts of the genus Candida spp due to local or systemic factors. The Australian Tea Tree Oil (TTO) is known as Melaleuca oil, one of the most important essential oils containing many therapeutically effective compounds. Australian Tea Tree Oil (TTO) is one of the most important essential oils that contain many compounds that are effective against many bacteria and fungi, which may match the effect of common antibiotics. Objective: The aim of this study was to isolate and diagnose fungi that causing vaginal thrush, in pregnant women and to study the effect of (pregnancy and pregnancy sequence and age) on the rate of infection compared to non-pregnant, as well as to study the drug sensitivity of isolates towards a number of antifungal and compared that with the inhibitory effectiveness of tea tree oil. TTO is highly effective in inhibiting the growth of opportunistic candida yeasts
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