Background
Methods
Isolation of microorganisms causing vaginitis infection
Identification of isolated Candida strains
Molecular identification of concerned Candida strains
Antifungal susceptibility test
Determination of minimum inhibitory concentration (MIC) of the most effective antifungal drug (terbinafine) against isolated Candida vaginitis strains
Determination of minimum fungicidal concentrations (MFCs) of the most effective antifungal drug (terbinafine)
Results
Sample collection and preliminary identification
Vaginal infections | Pregnant women | Non-pregnant women | Total patients no. | |||
---|---|---|---|---|---|---|
No. | Incidence % | No. | Incidence % | No. | Incidence % | |
Positive | 91.0 | 65.9 | 114.0 | 44.5 | 205.0 | 52.0 |
Negative | 47.0 | 34.1 | 142.0 | 55.5 | 189.0 | 48.0 |
Total | 138.0 | – | 256.0 | – | 394.0 | 100.0 |
Patients | Candida vaginitis | Bacterial vaginosis | Trichomoniasis | Total patients no. | ||||
---|---|---|---|---|---|---|---|---|
No. | Incidence% | No. | Incidence% | No. | Incidence% | No. | Incidence% | |
Pregnant | 59 | 64.8 | 32 | 35.2 | 0 | 0.0 | 91 | 44.4 |
Non-pregnant | 61 | 53.5 | 52 | 45.6 | 1 | 0.9 | 114 | 55.6 |
Total | 120 | 58.5 | 84 | 41.0 | 1 | 0.5 | 205 | 100.0 |
Vaginitis infection | Candida vaginitis | Bacterial vaginosis | Trichomoniasis | |||||
---|---|---|---|---|---|---|---|---|
Gram −ve | Gram +ve | |||||||
No. | % | No. | % | No. | % | No. | % | |
Single | 59.0 | 35.50 | 26.0 | 29.90 | 12.0 | 27.90 | 1.0 | 100.0 |
Mixed | 107.0 | 64.50 | 61.0 | 70.10 | 31.0 | 72.10 | 0.0 | 0.00 |
Total | 166.0 | – | 87.0 | – | 43.0 | – | 1.0 | – |
Age groups (years) | Pregnant women | Non-pregnant women | Total patients no | |||
---|---|---|---|---|---|---|
No. | Incidence% | No. | Incidence% | No. | Incidence% | |
25 < | 15 | 16.5 | 32 | 28.1 | 47 | 22.9 |
26–35 | 52 | 57.1 | 39 | 34.2 | 91 | 44.4 |
36–45 | 24 | 26.4 | 22 | 19.3 | 46 | 22.4 |
46–55 | 0 | 0.0 | 15 | 13.1 | 15 | 7.3 |
56 > | 0 | 0.0 | 6 | 5.3 | 6 | 2.9 |
Total no. | 91 | 44.4 | 114 | 65.9 | 205 | 100.0 |
Identification of isolated Candida strains
Molecular identification of concerned Candida strains
Antifungal susceptibility test
Antifungal agents | Conc. (µg/disc) | Chemical classes | Inhibition zone diameter (mm) | ||
---|---|---|---|---|---|
Resistant | Dose dependent | Sensitive | |||
Clotrimazole | 50 | Azoles | ≤ 11 | 12–19 | ≥ 20 |
Fluconazole | 25 | ≤ 16 | 15–18 | ≥ 19 | |
Itraconazole | 50 | ≤ 9 | 10–15 | ≥ 16 | |
Nystatin | 20 | Polyenes | ≤ 16 | 17–24 | ≥ 25 |
Terbinafine | 50 | Allylamines and thiocarbamates | ≤ 11 | 12–19 | ≥ 20 |
Antifungals | Conc. (μg/ml) | Inhibition zone diameter (mm) of the isolated vaginal candida strains | ||
---|---|---|---|---|
C. albicans | C. tropicalis | C. glabrata | ||
Clotrimazole | 50 | 11.07 ± 0.43 | 21.20 ± 0.64 | 0.00 ± 0.00 |
Fluconazole | 25 | 13.67 ± 0.09 | 24.10 ± 0.12 | 0.00 ± 0.00 |
Itraconazole | 50 | 17.93 ± 0.38 | 15.50 ± 0.46 | 0.00 ± 0.00 |
Nystatin | 20 | 12.73 ± 0.49 | 18.60 ± 0.12 | 15.53 ± 0.66 |
Terbinafine | 50 | 27.27 ± 0.08 | 24.40 ± 0.15 | 11.73 ± 0.91 |
Determination of minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC)
Terbinafine Conc. (μg/ ml) | Inhibition zone diameter (mm) of vaginal Candida strains | |
---|---|---|
C. albicans | C. tropicalis | |
1.25 | 0.00 ± 0.00 | 0.00 ± 0.00 |
2.50 | 0.00 ± 0.00 | 11.10 ± 0.06 |
5.00 | 9.20 ± 0.06 | 11.50 ± 0.05 |
10.0 | 12.80 ± 0.17 | 14.60 ± 0.17 |
20.0 | 14.20 ± 0.17 | 15.40 ± 0.12 |
40.0 | 17.23 ± 0.13 | 18.87 ± 0.15 |