Characterization of Candida species isolated from vulvovaginal candidiasis by MALDI-TOF with in vitro antifungal susceptibility profiles

Background and Purpose: Vulvovaginal candidiasis (VVC) is an opportunisticinfection due to Candida species, one of the most common genital tract diseases among reproductive-age women. The present study aimed to investigate the prevalence of VVC among non-pregnant women and identify the epidemiology of the involved Candida species with the evaluation of antifungal susceptibilities.Materials and Methods: Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) was performed to identify Candida species isolated from the genital tract of ۳۵۰ non-pregnant women. Moreover, antifungal susceptibility testing was performed according to the Clinical and Laboratory Standards Institute broth microdilution method guidelines (M۲۷-A۳ and M۲۷-S۴).Results: Vaginal swab cultures of ۱۱۹ (۳۴%) women yielded Candida species. Candidaalbicans was the most frequently isolated species (۶۸%), followed by Candida glabrata(۱۹.۲%). Voriconazole was the most active drug against all tested isolates showing anMIC۵۰/MIC۹۰ corresponding to ۰.۰۱۶/۰.۲۵ µg/mL, followed by posaconazole (۰.۰۳۱/۱µg/mL). Overall, resistance rates to fluconazole, itraconazole, and voriconazole were۲.۴%, ۴.۸% and, ۰.۸% respectively. However, posaconazole showed potent in vitro activity against all tested isolates.Conclusion: Results of the current study showed that for the effectual therapeuticoutcome of candidiasis, accurate identification of species, appropriate source control,suitable antifungal regimens, and improved antifungal stewardship are highly recommended for the management and treatment of infection with Candida, like VVC.

کلیدواژه ها:

Antifungal susceptibility ، Candida species ، MALDI-TOF ، Vulvovaginal candidiasis