Prevalence and Antibiotic Resistance Pattern of Candida spp. Isolated from Pregnant Women Referred to Health Centers in Ardabil, Iran

Candidiasis is a fungal infection which is caused by Candida spp. Candida albicans is the most common agent of candidiasis. This infection may cause various side effects during pregnancy including prematurity, chorioamnionitis, candidal pneumonia, and systemic candidiasis of infants. This research was conducted for determining the prevalence and antibiotic resistance pattern of Candida spp, collected from pregnant women admitted to health centers in Ardabil, Iran.
Totally, 408 subjects were included in this study. Demographic data and risk factors were recorded using a questionnaire. Two swab samples were taken from vulvovaginal mucus. One swab was used for preparing smear and direct microscopic examination and the second one used for cultivating the specimen. After identification of Candida spp., antimicrobial resistance pattern was determined by disk diffusion method against Fluconazole, Ketoconazole, Clotrimazole, Nystatin and Amphotericin B. Results were interpreted according to CLSI guidelines. The data were analyzed by χ2 and t-test using SPSS-19.
Out of 408 subjects, 143 cases (35%) were positive for candida spp. The Candida albicans with 119 (83.2%) cases was the most prevalent species followed by Candida glabrata, Candida krusei, Candida parpsilosis and Candida tropicalis.According to disk diffusion test, overall 116 (81.1%) isolates were resistant to Fluconazole, 100 (69.9%) to Ketoconazole, 67 (46.9%) to Clotrimazole and 25 (17.5%) to Amphotericin B. Candida spp. had a highest sensitivity (118, 82.5%) to Nystatin. For Candida albicans 97(81.5%) isolates were resistant to Fluconazole and 99(83.2%) isolates to Nystatin. For Candida glabrata 10 (90.9%) isolates were resistant to Fluconazole, and 9(81.8%) sensitive to Nystatin.
According to the results of this study, vulvovaginal candidiasis is prevalent among pregnant women in Ardabil and isolates were significantly resistant against commonly used antifungal drugs. Nystatin was the most effective against Candida spp. As antibiogram for fungal agents is not routinely performed, the similar periodical studies could be useful for choosing appropriate antibiotics in treatment of vulvovaginal candidiasis.