In vitro antifungal activity of aqueous-ethanolic extract of Allium jesdianum against fluconazole-susceptible and -resistant human vaginal Candida glabrata isolates

About 50% of women are diagnosed with an episode of vulvovaginal candidiasis (VVC) during first 25 years of their lives. Candida glabrata is considered the second most prevalent non-C. albicans species associated with VVC. In this study, we examined the antifungal effect of a medicinal plant, Allium jesdianum, as a natural therapeutic agent against fluconazole-susceptible and -resistant human vaginal C. glabrata isolates, collected from two groups of volunteers; healthy women and women with VVC.
An aqueous-ethanolic extract of A. jesdianum was prepared by maceration method. Vaginal specimens were collected from 28 women diagnosed with VVC and eight healthy subjects. The specimens were cultured using fungal-specific media in optimum conditions. The antifungal susceptibility of clinical isolates of C. glabrata to the plant extract and fluconazole was evaluated according to the standard protocols.
Candida glabrata was found to be the major cause of vaginal infection among 15.2% of women with VVC. We could identify the Candida spp. yeasts that colonized the vagina of 35% of healthy women while 19% of the isolated yeasts strains were detected as C. glabrata. Moreover, 7.1% of isolates obtained from VVC-patients were fluconazole resistant. The results showed the antifungal effect of A. jesdianum against all fluconazole resistant and susceptible C. glabrata vaginal isolates. The MIC90 of aqueous-ethanol (A-EtOH) extract of A. jesdianum against C. glabrata isolates from both VVC-patients and healthy women was 3 mg/mL.
Our results showed the promising antifungal efficacy of aqueous-ethanolic extract of A. jesdianum. A. jesdianum extract might be used as an alternative choice to treat the VVC infections caused by fluconazole resistant Candida spp.