Abstract
BackgroundVulvovaginal candidiasis is a global issue of concern due to its association with economic costs, sexually transmitted infections, and ascending genital tract infection. The aim of this study was to determine species distribution and antifungal susceptibility pattern of Candida species causing vulvovaginal candidiasis.MethodsA cross sectional study was conducted from November 2015 to December 2016 at the Family Guidance Association of Ethiopia. Vaginal swabs collected from study subjects that were clinically diagnosed with vulvovaginal candidiasis were cultured. Yeast identification and antifungal susceptibility testing were determined by the automated VITEK 2 compact system. The association of vulvovaginal candidiasis with possible risk factors was assessed and analyzed using SPSS version 20.ResultsThe overall prevalence of vulvovaginal candidiasis was 41.4%. The association of vulvovaginal candidiasis was statistically significant with previous genital tract infection (p = 0.004), number of life-time male sex partners (p = .037), and number of male sex partners in 12 month (p = 0.001). Of 87 Candida isolates recovered, 58.6% were C. albicans while 41.4% were non-albicans Candida species. The highest overall drug resistance rate of Candida species was observed against fluconazole (17.2%), followed by flycytosine (5.7%). All Candida isolates were 100% susceptible to voriconazole, caspofungin, and micafungin. C. albicans, was 100% susceptible to all drugs tested except fluconazole and flycytosine with a resistance rate of 2% each drug. C. krusei, was 100 and 33.3% resistant to fluconazole and flycytosine, respectively.ConclusionsHigh prevalence rate of vulvovaginal candidiasis and observation of high prevalence rate of non-albicans Candida species in the present study substantiate, the importance of conducting continuous epidemiological surveys to measure changes in species distribution from C. albicans to non-albicans Candida species in Ethiopia. Although, fluconazole still appeared to be active against all isolates of C. albicans and non-albicans Candida species high resistance rate of C. krusei against the drug may demonstrate a search for alternative antifungal drugs when treating vulvovaginal candidiasis caused by C. krusei.
Highlights
Vulvovaginal candidiasis is a global issue of concern due to its association with economic costs, sexually transmitted infections, and ascending genital tract infection
Period and area A cross sectional study was conducted from November 2015 to December 2016 at the Family Guidance Association of Ethiopian (FGAE) Addis Ababa model clinic
The adjusted odds ratio showed that vulvovaginal candidiasis was significantly associated with previous genital tract infection (p = 0.004)
Summary
Vulvovaginal candidiasis is a global issue of concern due to its association with economic costs, sexually transmitted infections, and ascending genital tract infection. The aim of this study was to determine species distribution and antifungal susceptibility pattern of Candida species causing vulvovaginal candidiasis. Vulvovaginal candidiasis here is defined as isolation of Candida species in culture from study participants with sign and symptom of vaginal abnormalities. Vulvovaginal candidiasis, bacterial vaginosis, and trichomoniasis are the most common cause of vaginitis of which vulvovaginal candidiasis is the second most common after bacterial vaginosis [1, 2]. Many studies [3,4,5,6,7,8], have reported that three fourth (75%) of women will experience an episode of vulvovaginal candidiasis in their lifetimes, 50% of these will experience at least a second episode, and 5–10% of all women experience recurrent vulvovaginal candidiasis i.e., ≥4 episodes of vulvovaginal candidiasis per year. The data supporting each of these factors are conflicting
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