Author/Authors :
Abbasi Nejat, Ziba International Campus - Iran University of Medical Sciences - Tehran, Iran , Farahyar, Shirin Department of Medical Parasitology and Mycology - School of Medicine - Iran University of Medical Sciences - Tehran, Iran , Falahati, Mehraban Department of Medical Parasitology and Mycology - School of Medicine - Iran University of Medical Sciences - Tehran, Iran , Ashrafi Khozani, Mahtab Department of Medical Parasitology and Mycology - School of Medicine - Iran University of Medical Sciences - Tehran, Iran , Ekhtiari, Masoome Department of Medical Parasitology and Mycology - School of Medicine - Iran University of Medical Sciences - Tehran, Iran , Hashemi-Hafshenjani, Saeideh Department of Medical Parasitology and Mycology - School of Medicine - Iran University of Medical Sciences - Tehran, Iran , Hosseini, Aga Fateme Department of Biostatistics - School of Public Health - Iran University of Medical Sciences - Tehran, Iran , Faiazy, Azamsadat Department of Gynecology - Sayyad Shirazi Hospital - Golestan University of Medical Sciences - Gorgan, Iran
Abstract :
Vulvovaginal candidiasis (VVC) is an important health problem caused by Candida spp. The aim of
this study was molecular identification, phylogenetic analysis, and evaluation of antifungal susceptibility of nonalbicans
Candida isolates from VVC. Methods: Vaginal secretion samples were collected from 550 vaginitis
patients at Sayyad Shirazi Medical and Educational Center of Gorgan (Golestan Province, Iran) from May to
October 2015. Samples were analyzed using conventional mycological and molecular approaches. Clinical isolates
were analyzed with specific PCR using CGL primers, and the internal transcribed spacer region and the D1-D2
domain of the large-subunit rRNA gene were amplified and sequenced. Susceptibility to amphotericin B,
fluconazole, itraconazole, and clotrimazole was determined by the guidelines of the Clinical and Laboratory
Standard Institute. Results: In total, 35 non-albicans Candida isolates were identified from VVC patients. The
isolates included 27 strains of Candida glabrata (77.1%), 5 Candida krusei (Pichia kudriavzevii; 14.3%), 2 Candida
kefyr (Kluyveromyces marxianus; 5.7%), and 1 Candida lusitaniae (Clavispora lusitaniae; 2.9%). The fungicides
itraconazole and amphotericin B were effective against all species. One isolate of C. glabrata showed resistance to
fluconazole and clotrimazole, and 26 isolates of C. glabrata indicated dose-dependent susceptibility to
fluconazole. C. lusitaniae was susceptible in a dose-dependent manner to fluconazole and resistant to
clotrimazole. Conclusions: Non-albicans Candida spp. are common agents of vulvovaginitis, and C. glabrata is the
most common species in the tested patients.
