The rate of antifungal resistance against Amphotericin B and Miconazole is increasing among candida species isolated from women suffer from recurrent vulvovaginal candidiasis in Iran

Vulvovaginal candidiasis affects at least one of two Females during their life and RVVC is characterized by ۳ or more episode of VVC per year. The main causative agent of VVC is Candida albicans with reminder caused by C.glabrata, C.krusei, C.parapsilosis, C.tropicalis. The purpose of this study was to isolate Candida from VVC patients, characterize it and test its susceptibility to two antifungal medications using the broth microdilution method. Swab samples of patients were obtained and VVC was confirmed by observation of budding yeast by providing direct smear by KOH ۳% and also positive culture in Sabouraud dextrose agar. We identified species by phenotyping methods and molecular methods (۲۱ plex PCR) and also assessed the rate of drug resistance by microdilution method against miconazole and amphotericin B(AMB). Among ۷۵ VVC and ۴۳ RVVC patients, The most common species were C.albicans (۷۳.۷%), C.glabrata (۱۶.۹%), C.krusei (۵.۱%), C.parapsilosis (۳.۴%), C.tropicalis (۰.۸%). AMB was active against every isolate from VVC patients except for ۱۸.۶% resistance in RVVC patients. In total, only ۱۰.۷% of VVC patients were resistant to miconazole whereas ۵۱% of RVVC patients were resistant to miconazole. Therefore, the identification of the causal agent, doing an antifungal susceptibility test (AFST), and genotypic identification will play a crucial role in the optimal selection of antifungal medication for the therapy in RVVC patients, especially those who lake any risk factors.

Keywords:

Recurrent vulvovaginal candidiasis(RVVC) , Drug resistance , Miconazole , Amphotericin B , Microdilution method