Balaji Lavanya, Subramaniam Jayakumar
Department of Microbiology, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND.
Cureus. 2024 Jul 28;16(7):e65601. doi: 10.7759/cureus.65601. eCollection 2024 Jul.
Background Vulvovaginal candidiasis (VVC) is a common fungal infection caused by an overgrowth of species, primarily (). Using HiCrome agar and tetrazolium reduction medium offers cost-effectiveness in detection by eliminating the need for additional tests, reducing equipment costs compared to automated systems, and simplifying workflow with direct species identification while maintaining high specificity. They expedite detection by directly identifying species based on colony colour, bypassing the multiple steps of phenotypic methods. This efficiency saves time in the laboratory, providing rapid results without the extended processing times associated with automated systems and facilitating prompt diagnosis and treatment decisions. These diagnostic tools are especially valuable in low-resource environments where a quick and accurate diagnosis of VVC is crucial for effective treatment and management of antifungal resistance. Aims and objectives This study aims to evaluate the efficacy of HiCrome agar and tetrazolium reduction medium's efficacy in speciating species in VVC cases. Materials and methods A cross-sectional observational study was conducted at Saveetha Medical College and Hospitals, Chennai, India, over six months. High vaginal swabs from 126 patients suspected of VVC were collected and plated on Sabouraud dextrose agar (SDA), HiCrome Candida differential agar (Himedia, Mumbai, India), and tetrazolium reduction medium. The results were compared with those obtained from the VITEK2 compact system (bioMérieux, Marcy-l'Étoile, France). Results Of the 126 samples, 74.6% showed single yeast infections, 7.9% displayed mixed yeast infections, and 17.5% showed no growth. A total of 114 isolates were identified. Both HiCrome agar and tetrazolium reduction medium accurately identified all isolates, with complete concordance with the VITEK2 compact system. The most commonly isolated species were (55.2%), (32.4%), (8.8%), and (3.6%). Both media provided rapid and accurate presumptive identification in low-resource settings. Conclusions HiCrome agar and tetrazolium reduction medium demonstrated high sensitivity and specificity in identifying Candida species. These methods are reliable for rapid and accurate diagnosis, particularly in resource-limited settings. However, they may require supplementary tests for definitive species identification. The adoption of these diagnostic tools represents a significant advancement in clinical microbiology, improving VVC management and addressing antifungal resistance.
外阴阴道念珠菌病（VVC）是一种常见的真菌感染，由念珠菌属物种过度生长引起，主要是白色念珠菌（白色假丝酵母菌）。使用HiCrome琼脂和四氮唑还原培养基在念珠菌检测中具有成本效益，因为它无需额外测试，与自动化系统相比降低了设备成本，并且通过直接进行菌种鉴定简化了工作流程，同时保持了高特异性。它们通过根据菌落颜色直接鉴定念珠菌物种来加快检测速度，绕过了表型方法的多个步骤。这种效率节省了实验室时间，无需像自动化系统那样长时间处理就能快速得出结果，有助于及时做出诊断和治疗决策。这些诊断工具在资源匮乏的环境中尤其有价值，在这些环境中，快速准确地诊断VVC对于有效治疗和管理抗真菌耐药性至关重要。
本研究旨在评估HiCrome琼脂和四氮唑还原培养基在VVC病例中对念珠菌物种进行分类鉴定的效果。
在印度钦奈的萨维塔医学院及医院进行了一项为期六个月的横断面观察性研究。收集了126例疑似VVC患者的高阴道拭子，接种于沙氏葡萄糖琼脂（SDA）、HiCrome念珠菌鉴别琼脂（印度孟买的Himedia公司生产）和四氮唑还原培养基上。将结果与VITEK2 compact系统（法国马西 - 埃图瓦勒的生物梅里埃公司生产）获得的结果进行比较。
在126份样本中，74.6%显示单一酵母菌感染，7.9%显示混合酵母菌感染，17.5%未生长。共鉴定出114株念珠菌分离株。HiCrome琼脂和四氮唑还原培养基均准确鉴定了所有分离株，与VITEK2 compact系统完全一致。最常分离出的物种是白色念珠菌（55.2%）、光滑念珠菌（32.4%）、热带念珠菌（8.8%）和近平滑念珠菌（3.6%）。两种培养基在资源匮乏的环境中都能提供快速准确的初步鉴定。
HiCrome琼脂和四氮唑还原培养基在鉴定念珠菌物种方面表现出高敏感性和特异性。这些方法对于快速准确的诊断是可靠的，特别是在资源有限的环境中。然而，它们可能需要补充测试以进行明确的物种鉴定。采用这些诊断工具代表了临床微生物学的重大进步，改善了VVC的管理并应对了抗真菌耐药性问题。
