Abstract: Background: Vulvo-vaginal candidiasis (VVC) remains one of the most common infections of the
female genital tract. It has been estimated that up to 75% of women will have at least one episode of vaginal
candidiasis during their lives. The aim of this study was to determine the frequency of Candida species isolation
from pregnant women with VVC and to study antifungal susceptibility, phospholipase and proteinase production by
the isolated Candida species.
Methods: The study was conducted on 100 female patients complaining of symptoms
of vulvovaginitis attending the Obstetrics and Gynecological Outpatient Clinic of Benha University Hospital from
June 2011 to April 2012. The test group included 50 pregnant women in the third trimester of pregnancy, while the
control group included 50 non-pregnant women in the childbearing period. Isolation and complete identification of
Candida species
was performed. Antifungal susceptibility testing was done by disc diffusion method and finally
detection of proteinase & phospholipase exoenzymes production was performed. Results: Results showed
significant higher number of positive cultures in pregnant women 56% (28/50) versus 34% (17/50) in non-pregnant
women (p=0.026). C. albicans was the most common species associated with VVC (71.4% in pregnant women
versus 64.7 % in non pregnant women). The results of in vitro antifungal susceptibility testing demonstrated that
100% of Candida kefrr (C.kehr), 96.7% of C.albicans, 66.6% of C.glabrata, 50% of C.tropicalis were found to be
sensitive to fluconazole. All Candida species tested were susceptible to voriconazole and nystatin (100%). There
was insignificant difference in the number of phospholipase and proteinase producing isolates of
C. albicans and
non albicans species
in pregnant and non pregnant women (p< 0.05). Conclusion VVC is more prevalent in
pregnant women. The best approach for the diagnosis of VVC is to consider microscopic examination of vaginal
secretion with culture. Due to its efficacy and low risk profile, nystatin remains the first line treatment for
Candida
infections during pregnancy. Phospholipase and proteinase activity do not have predominance in
Candida species
isolated from pregnant women with higher predominance in C.albicans than non albicans species in both groups.
[Sherin M Emam, Abeer A Abo Elazm and Ahmed Walid A. Morad. Exoenzymes Production and Antifungal
Susceptibility of Candida Species Isolated from Pregnant Women with Vulvovaginitis. J Am Sci
2012;8(12):1392-1399]. (ISSN: 1545-1003). http://www.iofamericanscience.org. |
