Prevalance, risk factors, molecular characterization of Candida spp., antifungal susceptibility patterns and evalution of virulence factors in patients presenting to the clinic with the complaint of vaginitis

Vulvovaginal candidiasis (VVC) is a common genital tract infection that affects millions of women worldwide. This study was prospectively conducted over a two-year period in a tertiary university hospital. In the study, vaginal swab samples (200 swabs) were taken from patients aged 18 years and older who presented to the Obstetrics and Gynecology outpatient clinic with signs and symptoms suggestive of vulvovaginitis. Demographic data were recorded using a questionnaire. Isolates were identified using standard microbiological methods and selected for identification Candida species using germ tube testing and molecular tests. Antifungal susceptibilities of Candida strains were determined by broth microdilution method. Virulence factors of Candida strains were determined by performing proteinase, phospholipase, hemolytic and biofilm activity tests. History of allergy (OR: 3.396; 95% CI: 0.968) was risk factor. Candida albicans was the most commonly isolated species 57 (57%), followed by Candida glabrata 26 (26%). It was found that 44 (77.2%) of the C. albicans strains had proteinase, 35 (61.4%) had phospholipase, 47 (82.5%) had biofilm, and 47 (82.5%) had hemolytic activity. In addition, all of Candida strains were found to be resistance to caspofungin, 16% to fluconazole and 4% to voriconazole. On the other hand, 64% of the strains were wild type for ketoconazole, 28% for posaconazole and 34% for voriconazole.