| dc.description.abstract | Objectives: To identify yeast isolates in vaginal specimens to species level and determine
their antifungal susceptibility patterns.
Design: Cross-sectional laboratory-based study.
Setting: The Aga Khan University Hospital (AKUH), Nairobi.
Subjects: Yeast isolates from high vaginal swabs presented to the laboratory for culture
and sensitivity were identified to species level using the API Candida system and
subjected to broth microdilution susceptibility testing.
Main outcome measures: Frequency tables and graphs were used to summarise the data.
Susceptibility data was analysed by the non-parametric Fisher’s exact test. P<0.05 was
considered statistically significant.
Results: A total of 101 yeasts were studied. C.albicans was the prominent species (69.3%)
followed by C. glabrata (12.9%), C. famata (5.0%), C. krusei (3.0%), Trichosporon species
(3.0%) and S.cerevisiae (3.0%), C.parapsilosis (1.0%). Three (3.0%) of the isolates had
profiles that fell between C. glabrata and C. famata. The percentages of C. albicans
susceptible to flucytosine, amphotericin B, fluconazole and itraconazole were 94.3,
92.9, 100 and 90 respectively; that of non-albicans isolates were 93.5, 80.6, 77.4 and 29
respectively. There was no significant difference (p>0.05) between the susceptibility
of C.albicans and non-albicans isolates to flucytosine and amphotericin B, however
there was a significant difference (p<0.05) to fluconazole and itraconazole.
Conclusions: C. albicans was the predominant cause of vulvovaginal candidiasis
in this study, and demonstrated good susceptibility to antifungal agents tested. A
significant number of non-albicans yeasts were identified; these demonstrated reduced
susceptibility to all drugs, in particular to the azoles which are commonly used for
treatment of vaginal candidiasis. The isolation of non-albicans yeasts may have clinical
implication given their reduced susceptibility to antifungals | en |
