Prevalence and comparison for detection methods of Candida species in vaginal specimens from pregnant and non pregnant Saudi women

摘要

Pregnancy represents a risk factor in the occurrence of vulvovaginal candidiasis. To investigate the prevalence rate of vaginal carriage of?Candida?species in Saudi pregnant and non-pregnant women,?high vaginal swab (HVS)?specimens (707) were examined by direct microscopy (10% KOH and Giemsa staining) and parallel cultured on Sabouraud Dextrose Agar (SDA) as well as on “CHROM agar Candida” medium.?As expected,Candida-positive cultures were frequently observed in pregnant-test group (24%) than in non-pregnant group (17%). The frequency of culture positive was correlated to pregnancy (P=0.047), parity?(P=0.001), use of contraceptive (P=0.146), or antibiotics (P=0.128), and diabetic-patients (P<0.0001). Out of 707 HVS examined specimens, 157 specimens were yeast-positive culture (22%) on Sabouraud Dextrose Agar or “CHROM agar Candida”.?In comparison, the sensitivities of the direct 10% KOH and the Giemsa stain microscopic examination methods were 84% (132/157) and 95% (149/157) respectively but both with 100% specificity.?As for the identity of recovered 157 yeast isolates, based on API 20C biotype carbohydrate assimilation, germ tube and chlamydospore formation,?C.?albicansand?C. glabrata?constitute 80.3 and 12.7% respectively. Whereas rates of?C. tropicalis, C. kefyr, C. famata or C. utilis?were 2.6, 1.3, and 0.6% respectively.?Sachromyces cerevisiae?and?Rhodotorula mucilaginosa yeasts?were also encountered at a frequency of 1.3 and 0.6% respectively.?Finally, among all recovered 157 yeast-isolates, strains resistant to ketoconazole were not detected, whereas 5% of the?C.?albicans?and as high as 55% of the non-albicans yeast isolates (majority?C. glabrata) showed resistance to fluconazole. Our findings may prove helpful for continuous determination of the existing vaginal candidiasis causative species during pregnancy, its lab-diagnosis and/or control and possible measures to minimize?the?incidence of the disease-associated pre-term delivery.