Antifungal Susceptibility Profile of Candida albicans Causing Vulvovaginal Candidiasis Among Pregnant Women

Abstract

Candida infection is a common disorder that can cause vulvovaginal candidiasis (VVC) among adult women. Candida albicans is the main etiologic agent of VVC. This study was to determine the antifungal susceptibility of C. albicans isolated from pregnant women in Hospital Tengku Ampuan Afzan (HTAA), Kuantan, Malaysia. A hundred and twenty-five isolates of yeast were cultured on Sabouraud dextrose agar (SDA) from a high vaginal swab (HVS). These yeast isolates were identified by the odor and morphology of the yeast colony, and were further identified by germ tube test and subsequently sub-cultured on CHROMagar Candida and cornmeal agar. The antifungal susceptibility test of C. albicans was carried out on Fluconazole and 5-Fluorocytosine using the Epsilometer test (E-test) method. A total of 30 C. albicans isolates were susceptible to 90% of Fluconazole and 100% of 5-Fluorocytosine. As for minimum inhibitory concentration (MIC) determined by the E-test method, Fluconazole showed that 13.3% of C. albicans was sensitive in the range of 0.023-0.19 µg/ml and 76.7% in a range of 0.25-2.0 µg/ml, while 56.7% was sensitive to 5-Fluorocytosine in range of 0.003-0.094 µg/ml and 43.3% in a range of 0.125-4.0 µg/ml. The resistance rate of Fluconazole was only 10%, which is in the range of 8-32 µg/ml. In this study, most of C. albicans was sensitive towards both antifungals which shows the effectiveness among VVC infection. In conclusion, the risk of multidrug resistance among C. albicans in the high vaginal swab (HVS) sample remains low, and the antibiotics used to treat VVC remain effective.