Vulvovaginal Candidiasis and Antifungal Susceptibility Pattern among Women in Aden Governorate, Yemen

Abstract

Background VVC is a complicated inflammatory infectious disease of the female genital tract caused by Candida genus. Most of studies in Yemen were not involved both risk factors and antifungal sensitivity patterns among VVC women. So this study was performed to evaluate risk factors contributed to the VVC and to evaluate the antifungals susceptibility patterns of Candida spp. among women in Aden, Yemen. Methods One hundred and two women were enrolled in this cross-sectional study; two high vaginal swabs were collected and tested microscopy and inoculated in SDA. Chromogenic medium was used to identified and differentiated the Candida species. Five available antifungal agents are used for sensitivity testing, include: ICZ, FCZ, KCZ, CLZ, NS, MCZ by Disc diffusion method. The data was finally analyzed by using SPSS® software (Version 21). Results A total of 102 women, the total mean ± SD age of women was 27.36 ± 7.7years, the min- max (16-47years). The overall frequency of VV among women was 39.2%. The highest rate was 22 (44.9%) in age group < 25. Five species of Candida were isolated where C. albicans was the most frequent in 55% of women, followed by C. krusei in 17.5%, C. glabrata in 12.5%, C. tropicalis in 10%. Significant association were found between the VVC and pregnancy and severity of symptoms (p = 0.066 and 0.0001), respectively. In the term of susceptibility testing for antifungal dugs, the overall resistance was 20% of CTZ, followed by 15%NS, 7.5% to KCZ and MCZ each and lowest rate of resistant was 2.5% for FCZ. All the five isolated species were 100% sensitive to ICZ. Conclusion It can be concluded from this study that the overall frequency of VVC among women in Aden-Yemen higher than that reported among Yemeni women while slightly lower than that reported globally. The infection was high among women in age group < 25.Among five isolated species C. albicans and C. krusei were the most frequent species. The pregnancy and severity of symptoms may increase the risk of VVC. Among five antifungal agents the resistant were found against CTZ, NS, KCZ, MCZ and FCZ while zero resistant to ICZ among those species. The resistant was increased among NAC.