Antifungal susceptibility pattern of Candida spp. isolated from vaginal discharge of pregnant women

Abstract

Vaginal candidiasis is common fungal infections among pregnant women. The aim of this study is to determine antifungal susceptibility pattern of Candida spp. isolated from vaginal discharge and to investigate possible risk factors associated with Candida infection. One hundred high vaginal swabs were collected from pregnant women complaining from abnormal discharge from various clinics in Gaza city, during 2019. Samples were plated on Sabouraud Dextrose Agar supplemented with chloramphenicol. Candida isolates were identified to the Genus level based on cultural and morphological characteristic. The susceptibility to seven antifungals was determined using disc diffusion method. Demographic, environmental, behavioral and other possible risks factors associated with vaginal candidiasis were recorded through an interview with patients before collecting the vaginal swabs and after obtaining a verbal consent. Data analysis was done using the SPSS software. Candida spp. was isolated from 43% of vaginal swabs of pregnant women with discharge. Variations existed in the susceptibilities of the different Candida isolates to antifungals. Amphotericin B the most effective with 0% resistance followed by itraconzaol and nystatin with 9.4% resistance. Resistance to miconazole, ketoconazole, voriconazole and fluconazole was 11.6%.  Statistically significant symptoms associated with positive Candida spp. cultures among pregnant women included; redness of vaginal area, secretions, yeast-like smell, urinary urgency, low sexual desire, itching and irritation (p ≤ 0.05). No statistical significance difference with regard to burning urinary sensation and painful intercourse. Candida spp. was isolated from 43% of vaginal swabs from pregnant women. Risks factors should be minimized by patient education and routine testing of pregnant women.