Year: 2025 | Month: August | Volume: 15 | Issue: 8 | Pages: 248-254
DOI: https://doi.org/10.52403/ijhsr.20250829
Vulvovaginal Candidiasis: Characterization of Etiologic Agent with Their Antifungal Susceptibility Pattern
Pradeep Paul1, Parijat Das2, Nidhi Pandey3
1,3Department of Microbiology, IMS, BHU, Varanasi, India
2Department of Molecular Medicine and Biotechnology, SGPGIMS, Lucknow, India.
Corresponding Author: Dr Nidhi Pandey
ABSTRACT
Introduction: Vulvovaginal candidiasis (VVC) remains one of the most common causes of gynecological consultations worldwide, with Candida albicans being the predominant etiological agent. In recent years, however, there has been a notable rise in cases caused by non-albicans Candida (NAC) species, many of which exhibit resistance to commonly used antifungal agents. This study aimed to investigate the spectrum of Candida species responsible for vulvovaginitis and to assess their antifungal susceptibility patterns at a tertiary care center in North India.
Material And Methods: A pair of High vaginal swabs (HVS) were collected from female patients exhibiting clinical features indicative of VVC. For each patient, one swab was processed for direct microscopic examination, while the second was cultured on Sabouraud Dextrose Agar (SDA) for the isolation of Candida species. Identification was performed using established mycological techniques, including the germ tube test, carbohydrate fermentation and assimilation tests, morphological assessment on cornmeal agar, and differentiation of colony coloration on HiCHROMagar. Antifungal susceptibility testing to fluconazole, voriconazole, amphotericin B, and caspofungin was conducted using the broth microdilution method, following Clinical and Laboratory Standards Institute (CLSI) M27-A3 guidelines. Isolates were categorized as susceptible, intermediate, or resistant according to interpretive breakpoints defined by CLSI document M60.
Results: A total of 101 non-duplicate Candida isolates were obtained, including 49 strains of C. albicans. Among the NAC species, C. tropicalis was the most prevalent (n = 20), followed by C. glabrata (n = 18) and C. krusei (n = 14). C. albicans (n=49) showed high susceptibility to all tested antifungals. C. tropicalis (n=20) was generally susceptible to all agents, though fluconazole MICs were slightly higher than those for C. albicans. C. glabrata (n=18) exhibited reduced susceptibility and C. krusei (n=14) displayed intrinsic resistance to fluconazole respectively but both remained sensitive to voriconazole, amphotericin B, and caspofungin.
Conclusion: This study provides valuable insights into the diverse etiological spectrum of vulvovaginal candidiasis and their respective antifungal susceptibility profiles. The findings highlight the importance of targeted antifungal stewardship and species-specific therapy to optimize treatment outcomes and reduce the burden of VVC among women.
Key words: Caspofungin, Non-albicans Candida, Broth microdilution method, fluconazole, C. albicans