Abstract:
Background: Vulvovaginal candidiasis (VVC) is a common
infection among women. Due to the emerging role of nonalbicans Candida in VVC, it is important to periodically
investigate the proportions of infection caused by different
Candida species and antifungal resistance patterns.
Aims: This study aims to determine the frequency of occurrence
of VVC in women presenting with vaginal discharge, possible
risk factors associated with the disease, and antifungal
susceptibility pattern of the isolates of Candida.
Materials and methods: High vaginal swabs from 158 women
presenting with vaginal discharge at the gynecology clinic
of Colombo South Teaching Hospital were studied. Ethical
approval was granted from the Ethical Review Committee of
the University of Sri Jayewardenepura (No.: 722/13). After
species identification, antifungal susceptibility tests were
performed using a standard disk diffusion technique. Probable
risk factors for the infection were assessed using an intervieweradministered questionnaire. Statistical analysis was performed
with Statistical Package for the Social Sciences (SPSS), using
chi-square tests. All inferential statistics were tested at p<0.05.
Results: Candida albicans was isolated in 34 patients (22%),
and Candida famata was isolated from one patient. All direct
microscopy-positive specimens were also culture positive. All
the isolates were susceptible to antifungals tested. Among the
study population, oral contraceptives (OCP) were used in 11%
(n=17) of patients (p=0.001). Fourteen (40%) of 35 Candida
positive patients had diabetes mellitus (p<0.05).
Conclusion: Candida albicans was the commonest species
isolated from VVC in a Sri Lankan setting. The infection can
safely be treated with commonly used antifungals. Diabetes
mellitus and use of OCP are associated risk factors.