Clinicomycological study of vulvovaginal candidiasis

BACKGROUND: Vaginal candidiasis is one of the most common vaginal infections in women of reproductive age group caused by Candida species of fungi, a normal inhabitant of vagina. AIMS: The aim is to study the culture characteristics, species prevalence, and drug sensitivity of vulvovaginal candidiasis (VVC) among females with genital pruritus and discharge per vaginum who are proved to have Candida infection by a vaginal smear study. MATERIALS AND METHODS: A prospective study was done on female patients aged 18 years attending the Sexually Transmitted Diseases Clinic of the Department of Dermato-Venereo-Leprology (DVL), Tirunelveli Medical College, with complaints of genital pruritus and vaginal discharge over a period of 1½ years from 2013 to 2015. After clinical examination, vaginal discharge was smeared for wet mount, potassium hydroxide mount, and Gram stain. Those with pseudohyphae were chosen for culture, speciation, and drug sensitivity. RESULTS: The most common age group affected was 18–35 years. The most common predisposing factor was HIV infection-induced immunosuppression (48.7%), followed by antibiotic usage and diabetes mellitus. Clinical presentation of VVC was similar in HIV-positive and HIV-negative patients. Recurrent VVC makes up 12% of total cases with most common species being Candida albicans whereas Candida glabrata among the non-C. albicans. Drug sensitivity pattern of C. albicans showed the highest sensitivity to nystatin 85.7%, followed by triazoles (75%–85%) with ketoconazole being more resistant (40%–60%), and was similar in C. albicans and non-C. albicans. LIMITATIONS: Exclusion of unmarried and pregnant women and lack of follow-up were limitations in our study. CONCLUSIONS: According to our study, elimination of predisposing factors, speciation of fungus, and treatment based on drug sensitivity pattern will reduce the incidence of VVC.