Medical Laboratory Science Department, Institute of Health, Bule Hora University, P.O. Box 144, Bule Hora City, Ethiopia.
BMC Pregnancy Childbirth. 2024 Sep 30;24(1):619. doi: 10.1186/s12884-024-06844-x.
Vulvovaginitis is common in women of reproductive age group characterized by purulent white discharge. The incidence of vulvovaginitis has risen recently due to the resistance of Candida species to commonly used antifungal agents and recurrent infections.
The study aimed to determine the prevalence, associated factors, and antifungal susceptibility patterns of vaginal candidiasis among pregnant women attending Bule Hora University Teaching Hospital.
A hospital-based cross-sectional study was conducted from May 2023 to August 2023. Using systematic random sampling, 317 pregnant women participated in the study. Sabouraud Dextrose Agar and Chromogenic Candida Differential Agar were used to isolate and identify Candida species from clinical samples. Antifungal susceptibility was performed using a modified disc diffusion method. Epi data version 4.6 was used for data entry and Statistical Packages for Social Sciences version 25 was used for statistical analysis. A P-value < 0.05 was declared statistically significant.
The prevalence of vaginal candidiasis was 26.8% (95%, CI 21.9-31.72%). History of using contraceptives (AOR = 5.03, 95%CI, 1.21-11.37), past vaginal candidiasis (AOR = 6, 95%CI, 1.61-12.92), pregnant women infected with human immunodeficiency virus (HIV) (AOR = 4.24, 95%CI, 1.23-14.14), diabetic mellitus (AOR = 2.17, 95%CI, 1.02-4.64), history of antibiotic use (AOR = 3.55, 95%CI, 1.67-12.75), pregnant women in third trimester (AOR = 8.72, 95%CI, 1.30-23.07), were the significantly associated factors for vaginal candidiasis. The study revealed that itraconazole, amphotericin B, and miconazole were the most effective antifungal drugs for all Candida isolates.
The present study has identified a high prevalence of vaginal candidiasis among pregnant women. The isolated Candida species showed resistance to fluconazole, ketoconazole, and clotrimazole. Therefore, healthcare providers should increase awareness of the risks of Candida infections to reduce Candida species among pregnant women. Physicians should prescribe suitable medications based on antifungal drug test outcomes to treat pregnant women with vaginal candidiasis.
外阴阴道念珠菌病是育龄妇女中常见的疾病，其特征为脓性白色分泌物。由于念珠菌对常用抗真菌药物的耐药性以及复发性感染，外阴阴道念珠菌病的发病率最近有所上升。
本研究旨在确定布卢赫拉大学教学医院就诊的孕妇中阴道念珠菌病的流行率、相关因素和抗真菌药敏模式。
本研究采用 2023 年 5 月至 8 月期间的医院横断面研究设计。采用系统随机抽样方法，共有 317 名孕妇参与了研究。采用沙氏葡萄糖琼脂和显色念珠菌鉴别琼脂从临床标本中分离和鉴定念珠菌。采用改良的纸片扩散法进行抗真菌药敏试验。EpiData 版本 4.6 用于数据录入，SPSS 版本 25 用于统计分析。P 值<0.05 被认为具有统计学意义。
阴道念珠菌病的流行率为 26.8%（95%CI，21.9-31.72%）。使用避孕药（AOR=5.03，95%CI，1.21-11.37）、既往阴道念珠菌病（AOR=6，95%CI，1.61-12.92）、感染人类免疫缺陷病毒（HIV）（AOR=4.24，95%CI，1.23-14.14）、糖尿病（AOR=2.17，95%CI，1.02-4.64）、使用抗生素（AOR=3.55，95%CI，1.67-12.75）、孕晚期（AOR=8.72，95%CI，1.30-23.07）的孕妇是阴道念珠菌病的显著相关因素。研究表明，伊曲康唑、两性霉素 B 和咪康唑对所有念珠菌分离株均具有最有效的抗真菌作用。
本研究发现孕妇中阴道念珠菌病的流行率较高。分离出的念珠菌对氟康唑、酮康唑和克霉唑表现出耐药性。因此，医疗保健提供者应提高对念珠菌感染风险的认识，以减少孕妇中念珠菌的数量。医生应根据抗真菌药物试验结果开出合适的药物来治疗患有阴道念珠菌病的孕妇。
