Abstract: Background: Vulvo-vaginal candidiasis (VVC) remains one of the most common infections of thefemale genital tract. It has been estimated that up to 75% of women will have at least one episode of vaginalcandidiasis during their lives. The aim of this study was to determine the frequency of Candida species isolationfrom pregnant women with VVC and to study antifungal susceptibility, phospholipases and proteases production bythe isolated Candida species. Methods: The study was conducted on 100 female patients complaining of symptomsof vulvovaginitis attending the Obstetrics and Gynecological Outpatient Clinic of Benha University Hospital fromJune 2011 to April 2012. The test group included 50 pregnant women in the third trimester of pregnancy, while thecontrol group included 50 non-pregnant women in the childbearing period. Isolation and complete identification ofCandida species was performed. Antifungal susceptibility testing was done by disc diffusion method and finallydetection of proteinase & phospholipase exoenzymes production was performed. Results: Results showedsignificant higher number of positive cultures in pregnant women 56% (28/50) versus 34% (17/50) in non-pregnantwomen (p=0.026). C. albicanswas the most common species associated with VVC (71.4% in pregnant womenversus 64.7 % in non pregnant women). The results of in vitro antifungal susceptibility testing demonstrated that100% of Candida kefyr (C.kefyr), 96.7% of C.albicans, 66.6% of C.glabrata, 50% of C.tropicaliswere found to besensitive to fluconazole. All Candida species tested were susceptible to voriconazole and nystatin (100%). Therewas insignificant difference in the number of phospholipase and proteinase producing isolates of C. albicansand
nonalbicans species in pregnant and non pregnant women (p< 0.05). Conclusion VVC is more prevalent inpregnant women. The best approach for the diagnosis of VVC is to consider microscopic examination of vaginalsecretion with culture. Due to its efficacy and low risk profile, nystatin remains the first line treatment for Candidainfections especially in the first pregnancy trimester. Phospholipase and protease activity do not have predominancein Candida species isolated from pregnant women with higher predominance in C.albicansthan non albicansspecies in both groups.
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