Typing candidas isolated from vaginal samples and determinating antifungal susceptibility via broth microdilution

Types of Candida is the second most common vulvovaginit agent worldwide. Clinical Picture includes complaints of white and thick or thin vaginal discharge and burning with urination. Infection has been related to rash in vulvoganital mucosa and also in perianal region. In this study, identification of Candidas and determination of antifungal resistance cases isolated from vaginal samples have been aimed. 100 (%20.8) Candida strains determinated in vaginal sample cultures taken with the purpose of searching for yeast from 481 patients who consulted Clinics of Gynecology and Obstetrics, University of Gaziantep Şahinbey Research and Application Hospital, with the complaints of vaginal discharge and pruritus, have been evaluated. Identification of isolated Candidas has been made by the use of chromogenic agar mediums and automatic identification method in addition to classical methods. Amphotericin B, itraconazole, fluconazole, ketoconazole, voriconazole and caspofungin susceptibility of the yeast, has been researched with the utility of reference broth microdilution method in the documents of Clinical and Laboratory Standards Institute (CLSI) M27-A3, M27-S3 and M27-S4. 21 female patients (21%) out of 100 in whom vulvovaginal candidiasis (VVC) agents have been determinated are between 18 and 25 years old, 40 (40%) of whom are between the ages of 26 and 40 and 39 (39%) of whom are 40 and above. Whereas 42 % of the patients had recurrent yeast infection, 58% of them had acute yeast enfection. 13% of the patients were the patients with the diagnosis of Diabeties Mellitus. 47 % of 100 Candida strains isolated from vaginal samples have been identified as Candida albicans, 43 % of them as C.glabrata, 5% of them as C.kefyr, 2% of them as C.krusei, 2% of them as C.tropicalis, 1% of them as C.guilliermondii. In our study, MIC ranges of antifungals 0.25-1 µg/mL for amphotericin B, 0.0313-16 µg/mL for itraconazole, 0.125-64 µg/mL for fluconazole, 0.0313-16 µg/mL for ketoconazole, 0.0313-16 µg/mL for voriconazole, 0.015-2 µg/mL for caspofungin have been detected. 13% of isolated Candida strains have been detected to become resistant to caspofungin, 12% of them to fluconazole, 42% of them to itraconazole. 14 (24.6 %) of Candidas other than C.glabrata have been detected to be voriconazole-resistant, whereas no strains which are resistant to amphotericin B have been detected. Strains with an MIC value ≥16 µg/mLwere considered resistant, 3 (3%) of isolated Candidas have been detected resistant to ketoconazole. In our study, C.glabrata has been the most frequently detected agent after C.albicans in vaginal candidiasis. Resistance rates detected towards azoles which are used in the systemic treatment and resistance of caspofungin are remarkable.