Sensitivity of Vaginal Isolates of Candida to Eight Antifungal Drugs Isolated From Ahvaz, Iran

Background: Candida vaginitis is a common fungal infection among adult women and it has been estimated that 75% of all adult women experience at least one period of vulvovaginal candidiasis in their lifetime. Several predisposing factors, such as diabetes mellitus, using contraceptive, pregnancy, and broad-spectrum antibiotics are reported as main risk factors for the infection. While, the main etiologic agent of vulvovaginal candidiasis is Candida albicans, more antifungal resistance has been reported among non-albicans species. Objectives: The aim of the present study was to determine susceptibility patterns of vaginal isolates of Candida to eight antifungal drugs including, clotrimazole, miconazole, terbinafine, nystatin, itraconazole, fluconazole, ketoconazole, and econazole. Patients and Methods: Tested organisms were C. albicans 53 (79.1%), C. glabrata 8 (11.9%), C. tropicalis 4 (5.9%) and C. krusei 2 (2.9%) that were isolated from vaginal infected patients. Disk diffusion method was used to evaluate susceptibility patterns. Paper disks containing clotrimazole, miconazole, itraconazole, fluconazole, ketoconazole, econazole, nystatin and terbinafine were applied for susceptibility tests. Results: In the present study 2 isolates of C. krusei were sensitive to ketoconazole, clotrimazole and miconazole. In addition both isolates were resistant to fluconazole, nystatin, econazole and terfinafine. Only one isolate of C. tropicalis was sensitive to miconazole and terbinafine and two isolates to clotrimazole. Highest sensitivity of C. albicans to antifungal drugs was seen against miconazole (49 of 53 isolates) followed by, clotrimazole (41), terbinafine (28) and ketoconazole (13) whereas 43 isolates were resistant to fluconazole and econazole antifungals. Conclusions: All 8 isolates of C. glabrata were resistant to fluconazole, whereas all isolates were sensitive to miconazole. Antifungal sensitivity testing suggests that vaginal isolates of Candida were most sensitive to miconazole, clotrimazole, and terbinafine, and least sensitive to econazole and fluconazole.