Determination of Drug Susceptibility of Candida Strains Isolated From Patients With Recurrent Candida Vulvovaginitis and Investigation of Predisposing Factors of the Disease

Recurrent Vulvovaginal Candidiasis (RVVC), which is mostly caused by Candida albicans (C. albicans), is the second common cause of genital tract infection in females. The purpose of this research was to identify Candida isolates from RVVC, identify predisposing factors and determine antifungal effect of fluconazole against Candida strains isolated from the patients.
In this descriptive-laboratory study, 20 patients with confirmed diagnosis of RVVC were selected. Yeast isolates were characterized using mycological standard methods, including culture on Sabouraud dextrose agar medium and CHROM agar, germ tube test and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. The susceptibility of Candida isolates against fluconazole was determined by microdilution broth method.
The average age of the patients was 29.43 ± 4.63 years. Candida albicans was obtained from 100% of the samples. The most common clinical sign was vaginal discharge (60%) in females with positive culture. Statistical correlations were observed between parturition frequency and low RVVC occurrence as well as between the previous antifungal therapy and RVVC occurrence. The mean minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) of fluconazole against different C. albicans strains was determined as 45.3863 µg/mL and 63 µg/mL, respectively.
Due to the uncertainty of diagnosis of this disease according to clinical symptoms and also, due to the resistance of Candida species, using culture and molecular methods are recommended as standard methods of diagnosis.