• Prevalence, drug resistance pattern and genotype analysis of Candida Species in patients with vulvovaginal candidiasis from Zanjan, Iran
  • Sahar Serajian,1,* Saeid Amanloo,2 Farzaneh Ahmadi,3 Masoomeh zanjani,4 Firoozeh kakavand,5
    1. Department of Medical Laboratory Sciences, School of Paramedical Sciences, Zanjan University of Medical Sciences, Zanjan, Iran
    2. Department of Parasitology and Mycology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
    3. Department of Medical Laboratory Sciences, School of Paramedical Sciences, Zanjan University of Medical Sciences, Zanjan, Iran
    4. Department of Medical Laboratory Sciences, School of Paramedical Sciences, Zanjan University of Medical Sciences, Zanjan, Iran
    5. Zanjan University of Medical Sciences, Zanjan, Iran


  • Introduction: Candida infection is one of the most common causes of vulvovaginitis in women. In recent decades, due to the increased use of broad-spectrum azole agents, resistance to Candida species has been reported. With molecular characterization, better assessment of isolates is feasible and can aid us to find prevention strategies and more precise detection. The aim of this study was to determine species distribution, antifungal susceptibility pattern of Candida species and genotype analysis of isolates causing vulvovaginal candidiasis.
  • Methods: In this study, 140 patients with suspected vulvovaginal candidiasis were examined. Samples were inoculated onto Sabouraud Dextrose Agar (SDA) and CHROMagar. After identification, isolates were tested for in-vitro susceptibilities fluconazole, itraconazole and ketoconazole as described by the Clinical Laboratory Standards Institute (CLSI) M27-A3 and M27-S4 document guidelines. Then, we reported a PCR system targeting 25S rDNA and ALT repeat sequences in the repetitive sequence (RPS) for genotyping of C. albicans. And data has been analyzed with SPSS.
  • Results: In total, 41 (29.3%) colonies of Candida spp. were isolated from 140 patients with Vulvovaginal Candidiasis. The most common identified species of Candida were C. glabrata (56.1%) and C. albicans (39%). The results indicate high resistance to azole drugs, as resistance to ketoconazole, itraconazole and fluconazole was found to be 65.9%, 5 and 58.5% and 26.8%, respectively. Genotype A3 C. albicans with 5 isolates (31.25%) constituted the majority of the isolates, followed by B2/3 with 4 isolates (25%) and A3/4 ، C3/4 و B3/4 with 2 isolates (12.5%) and C2/3 C3 with 1 isolate (6.25%), respectively.
  • Conclusion: The results showed that non-albicans species of Candida are more frequent than C. albicans in patients with vulvovaginal candidiasis. This result is consistent with some recent studies indicating that non-albicans species of Candida has increased and must be considered in gynecology clinics due to the reported azole resistance in these species. Also it is important to conduct continuous epidemiological surveys to measure drug resistance profile and epidemiological changes. Genotyping of isolates indicate that PCR amplifications targeting 25S rDNA and ALT repeats are useful for rapid genotyping and distinction of C. albicans in small scale and epidemiological surveys. In this study, like other studies Genotype A3 C. albicans have been the major type. But reports about genes A, B ,C are different .The reason for this variation can be because of the genomic variability within the Candida species.
  • Keywords: Candida, Vulvovaginitis, Drug resistance, ALT repeat, RPS