Rezaei-Matehkolaei Ali, Shafiei Shokoofe, Zarei-Mahmoudabadi Ali
Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Department of Medical Mycology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Iran J Microbiol. 2016 Dec;8(6):410-417.
Vulvovaginal candidiasis is a common fungal infection among women during reproductive ages. Although, is accounted as the main etiologic agent of vaginitis, non- species have arisen during last years. Resistant to antifungal drugs especially, fluconazole has been more reported by researchers from around the World. The aims of this study were to determine the prevalence of vulvovaginal candidiasis among suspected patients with vaginitis, the frequency of species, and the susceptibility profiles of isolates to caspofungin, fluconazole and clotrimazole.
One hundred and twenty suspected women with vaginitis were examined by specialist physician and sampled using moisture swabs. Swabs were inoculated on CHROMagar plates, incubated at 35°C and detected all isolated species using morphological, microcopy and molecular methods. The antifungal susceptibility tests with caspofungin, fluconazole and clotrimazole were applied using microdilution and Resazurin dye methods against all isolated yeasts.
The cultures were positive for 34(28.3%) samples and three species including; (88.2%), (8.8%) and (2.9%). Our study shows that only one isolate of was resistant to caspofungin at the concentration of 2 μg/ml after 24h incubation that increased to 2 isolates after 48h incubation. All isolates were sensitive to fluconazole at the MIC ranges of 1-0.25 μg/ml, while 88.2% of them were inhibited at 0.25 μg/mL of clotrimazole. remains the most common agent of fungal vaginitis.
Although all of isolates were susceptible to fluconazole , it should be used with caution for empirical therapy due to more resistant rates in clinic. In addition, due to valuable sensitivity of all tested strains to caspofungin, it potentially can be presented as the first line therapy for vaginitis.
外阴阴道念珠菌病是育龄期女性常见的真菌感染。尽管白色念珠菌被认为是阴道炎的主要病原体,但近年来非白色念珠菌菌种不断出现。世界各地的研究人员更多地报道了念珠菌对抗真菌药物尤其是氟康唑的耐药情况。本研究的目的是确定疑似阴道炎患者中外阴阴道念珠菌病的患病率、念珠菌菌种的频率以及分离株对卡泊芬净、氟康唑和克霉唑的敏感性。
120名疑似阴道炎女性由专科医生进行检查,并使用湿棉签采样。将棉签接种在科玛嘉念珠菌显色培养基平板上,于35°C孵育,并使用形态学、显微镜检查和分子方法检测所有分离出的念珠菌菌种。采用微量稀释法和刃天青染料法对所有分离出的酵母菌进行卡泊芬净、氟康唑和克霉唑的抗真菌药敏试验。
34份(28.3%)样本培养呈阳性,分离出三种念珠菌菌种,分别为白色念珠菌(88.2%)、光滑念珠菌(8.8%)和热带念珠菌(2.9%)。我们的研究表明,仅1株白色念珠菌在孵育24小时后对浓度为2μg/ml的卡泊芬净耐药,孵育48小时后增至2株。所有分离株在1 - 0.25μg/ml的最低抑菌浓度范围内对氟康唑敏感,而88.2%的分离株在0.25μg/mL的克霉唑浓度下受到抑制。白色念珠菌仍然是真菌性阴道炎最常见的病原体。
尽管所有白色念珠菌分离株对氟康唑敏感,但由于临床耐药率较高,在经验性治疗中应谨慎使用。此外,由于所有测试菌株对卡泊芬净具有较高的敏感性,它有可能作为外阴阴道念珠菌病的一线治疗药物。