Detection and characterisation of candida species in patients with clinical cervico-vaginal infections

Lyngdoh Clarissa J., Baruah Melody., Choudhury Basabdatta., Lyngdoh W. Valarie., Agarwal Manika and Mawlong Wandarity

Introduction: Approximately 75% of all women suffer from VVC once during their lifetime with 5-8% of them suffering from recurrent episodes. Though Candida albicans is associated in 70-80% of cases, infection by non-albicans Candida species is on the rise. Emergence of more resistant species has stressed the importance of monitoring antifungal susceptibility of the various Candida species.

Objective: To determine the species distribution and antifungal susceptibility among Candida isolates from patients with VVC and to do a comparative analysis of different methods of detection of the Candida isolates.

Materials and Methods: The study was conducted over a period of 2 years and included 279 patients. The Candida isolates were identified using the Conventional technique, ChromAgar and Automated system (Vitek 2 Compact). Antifungal susceptibility was performed using the Vitek 2 ID cards.

Results: Of the 279 women, 122 had positive culture for Candida species. Of the 136 Candida species isolated, C. albicans was predominant (36%). The predominant Non-albicans species isolated was C.glabrata (31.6%), C. tropicalis (17.6%) and C.lusitaniae (7.3%). There was agreement between the Conventional, ChromAgar and automated system in the majority of samples. All of the isolates showed sensitivity to the different antifungal agents.

Conclusion: VVC is common, hampers normal life and propensity for recurrence highlights better understanding of its cause. Since non-albicans Candida species are emerging, identification through reliable and rapid techniques is essential for proper decision making. Rapid test using ChromAgar supplemented with an automated system may be a reliable method of detection of the different Candida species. The psychological, medical and socio-economic impact of VVC is underestimated, hence a complete mycological workup becomes mandatory.

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