IJCRR - 7(24), December, 2015
ISOLATION AND SPECIES IDENTIFICATION OF CANDIDA ISOLATED FROM PATIENTS OF VULVOVAGINAL CANDIDIASIS IN A TERTIARY CARE HOSPITAL
Author: Twinkle Gandhi, Manish G. Patel, Mannu Jain
Introduction: An increase in the predisposing conditions in recent years has resulted in an increasing incidence of Candida infections.The accurate species identification of Candida is important for the treatment, as not all species respond to the same treatment and also because of the problem of anti-fungal resistance in certain species.Therefore, the species level identification of the Candida isolates, along with their anti-fungal susceptibility patterns can greatly influence the treatment options for the clinician. Objective: - To detect prevalence of Candida in patients with vaginal discharge. - To identify species of Candidaisolates. Methods: This study included 410 women with abnormal vaginal ischarge. Two high vaginal swabs were collected and sent immediately to the laboratory. All vaginal samples were stained with gram’s stain and oval budding yeast cells were identified as Candida. Second swab was inoculated on Sabouraud’s Dextrose agar and Candida isolates(n=122)were identified at species level by battery of various tests like GTT,Corn meal agar, Carbohydrate fermentation, Carbohydrate assimilation and CHROM agar inoculation. Results: Out of 410 samples Candida were isolated in 122 samples. Amongst the 122 Candida isolates highest was C.albicans 66.39%,followed by C.glabrata 15.65%,C.tropicalis 9.85%, C.parapsilosis 4.91%, C.krusei 2.4% and least wasC.guilliermondii 0.8%.In pregnancy and OCP users maximum isolates were of C.albicans(78.04% and 55.55%,respectively) were as in diabetic patients C.glabrata (47.05%) was predominant isolate,while in HIV positive patients all isolates wereC.albicans (100%). Conclusions: In our study the prevalence of VVC is 29.75%.Commonest species found was C.albicans 66.39%.VVC is more common in females with associated risk factors like pregnancy, diabetes, HIV and OCP users.Commonest species in pregnancy, OCP users and HIV patients wasC.albicans whileC.glabratawas more common in diabetic patient.
Keywords: Vulvovaginal candidiasis (VVC), Candida Spp., Germ tube test (GTT), CHROM agar
Twinkle Gandhi, Manish G. Patel, Mannu Jain. ISOLATION AND SPECIES IDENTIFICATION OF CANDIDA ISOLATED FROM PATIENTS OF VULVOVAGINAL CANDIDIASIS IN A TERTIARY CARE HOSPITAL International Journal of Current Research and Review. 7(24), December, 06-12
1. V. P. Baradkar, M. Mathur, S. KumarHichrom. Candida agar for identification of Candida Species.Indian Journal of Pathology and Microbiology-53(1)January-March 2010.
2. Shivanand Dharwad, Saldanha Dominic R.M.Species Identification of Candida Isolates in Various Clinical Specimens with Their Antifungal Susceptibility Patterns Journal of Clinical and Diagnostic Research. 2011 November (Suppl-1), Vol-5(6): 1177-1181.
3. Sayyada Ghufrana Nadeem, Shazia Tabassum Hakim,Shahana Urooj Kazmi.Use of CHROMagar Candida for the presumptive identification of Candida species directly from clinical specimens in resource-limited settings Libyan J Med 2010, 5: 2144 - DOI: 10.3402/ljm.v5i0.2144
4. Kelen F. D. Dota, Alessandra R. Freitas, Marcia E. L. Consolaro, Terezinha I. E. Svidzinski.A Challenge for Clinical Laboratories: Detection of Antifungal Resistance in Candida Species Causing Vulvovaginal Candidiasis. Journal of Lab medicine February 2011 Volume 42 Number 2.
5. Sandra S. Richter, Rudolph P. Galask,Shawn A.et al.Antifungal Susceptibilities of Candida Species Causing Vulvovaginitisand Epidemiology of Recurrent Cases Journal Of Clinical Microbiology, May 2005, p. 2155–2162.
6. Kikani K M. Species Distribution And Antifungal Susceptibility Pattern In The Cases Of Vaginal Candidiasis In Saurashtra Region Of Gujarat. Electronic Journal of Pharmacology and Therapy.January 1,2010.
7. Latha Ragunathan, Poongothai G.K, Annie Rofeena Sinazer et al Characterization and Antifungal Susceptibility Pattern to Fluconazole in Candida species Isolated from Vulvovaginal Candidiasis in a Tertiary Care HospitalJournal of Clinical and Diagnostic Research. 2014 May, Vol-8(5): DC01-DC04.
8. Sherin M Emam, Abeer A Abo Elazm and Ahmed Walid A.Exoenzymes Production and Antifungal Susceptibility of Candida Species Isolated from Pregnant Women with Vulvovaginitis. Journal of American Science 2012;8(12).
9. Doddaiah Vijaya, Tumkur Anjaneya Dhanalakshmi, Sunanda Kulkarni.Changing Trends of Vulvovaginal Candidiasis Journal of Laboratory Physicians / Jan-Jun 2014 / Vol-6 / Issue-1.
10. Oviasogie FE, Okungbowa FI. Candida species amongst pregnant women in Benin city, Nigeria: Effect of predisposing factors. Afr J Clin Exper Microbiol 2009;10:92-8.
11. Neerja J,Aruna A,Paramjeet G. Significance of Candida culture in women with vulvovaginal symptoms. J Obstet Gynecol India 2006;56:139-41.
12. Kelen F. D. Dota, Alessandra R. Freitas, Marcia E. L. Consolaro, Terezinha I. E. Svidzinski.A Challenge for Clinical Laboratories: Detection of Antifungal Resistance in Candida Species Causing Vulvovaginal Candidiasis. Journal of Lab medicine February 2011 Volume 42 Number 2.
13. R.Goswami,V Dadhwal,S.Tejaswi et al.Species-specific prevalence of vaginal Candidiasis among patients with Diabetes mellitus and its relation to their glycemic status Journal of infection (2000)41,162-166 .
14. Debarti Ray ,Ravinder Goswami, Uma Banerjee et al. Prevalence of Candida glabrata and Its Response to Boric Acid Vaginal Suppositories in Comparison With Oral Fluconazole in Patients With Diabetes and Vulvovaginal Candidiasis;Diabetes and vulvovaginal candidiasis;Diabetes Care, volume 30, number 2, february 2007.
15. Reza Faraji, Mehr Ali Rahimi, Fatemeh Rezvanmadani and Masoud Hashemi: Faraji et al.Prevalence of vaginal candidiasis infection in diabetic women10 January, 2012.
16. Abdullah Al-mamari, Mahmoud Mahyoob Al-buryhi and Sadeq Al-hag.Species-specific prevalence of vaginal candidiasis with type 1 and type 2 diabetes mellitus among women in Sana’a city Journal of Chemical and Pharmaceutical Research, 2013, 5(8): 217-224.
17. Luciana Basili Dias, Márcia de Souza Carvalho Melhem, Maria Walderez Szeszs et al.
18. Vulvovaginal Candidiasis In Mato Grosso, Brazil: Pregnancy Status, Causative Species And Drugs Tests. Brazilian Journal of Microbiology (2011) 42: 1300-1307.
19. Rui Fernandes Ana Viegas Fatima CerqueiraCandida Species distribution in clinical samples Revista da Faculdade de Ciencias da Saude.ISSN 1646-0480. 6 (2009) 264-271.
20. Patrick Williams Narkwa B.Sc (Hons) ;Antifungal Susceptibility Of Candida Species And Cryptococcus Neoformans Isolated From Patients At The Komfo Anokye Teaching Hospital In Kumasi;February, 2010.
21. Chander J. Candidiasis. In: A textbook of Medical Mycology, 3rd ed. Mehta Publishers, New Delhi, 2009; 266-90.
22. Fran Fisher,Norma cook,Fundamentals of diagnostic mycology,Philadelphia.W.B saunders company 1998;197-222.
23. Deepa Babin, Subbannayya Kotigadde, P.Sunil Rao et al. Clinico-mycological profile of vaginal candidiasis in a tertiary care hospital in Kerala International Journal of Research in Biological Sciences 2013; 3(1): 55-59.
24. Veena Manjunath , Vidya GS, Archana Sharma, Mridula Raj Prakash et al. Speciation of Candida by Hicrome agar and Sugar assimilation test in both HIVinfected and non infected patients. Int J Biol Med Res. 2012; 3(2):1778-1782.
25. J.E. Hoppe, P. Frey;Hoppe et al;Evaluation of Six Commercial Tests and the Germ-Tube Test for Presumptive Identification of Candida albicans ;Eur J Clin Microbiol Infect Dis (1999) 18 :188–191.
26. Arthur E. Crist, Theresa J. Dietz, And Kristin Kampschroer; Comparison of the MUREX C. albicans, Albicans-Sure, and BactiCard Candida Test Kits with the Germ Tube Test for Presumptive Identification of Candida albicans; Journal Of Clinical Microbiology, Oct. 1996, p. 2616–2618, Vol. 34, No.10