Species distribution and antifungal sensitivity, patterns of vaginal yeasts at the Aga khan University Hospital
Abstract
Species-level identification of yeasts and antifungal susceptihility testing is
not a common practice in Kenya. Thus there is limited information on the distribution of
yeast species causing vaginal infections and their susceptibility patterns to antifungal
agents.
To identify yeast isolates in vaginal specimens to species level and
determine their antifungal susceptibility patterns to llucytosine (SFC), amphotericin B
(AMB), fluconazole (FCA) and itraconazole (lTR).
Cross-sectional in vitro study
Aga Khan University Hospital (AKUH), Nairobi
One hundred and one yeasts isolated from women with vaginal discharge were
identified to species level using the API Candida system. The isolates were then
subjected to broth microdilution susceptibility testing and data was analyzed usingSl'S'S
for Windows version 12.0.
Calbicans was the prominent species (69.3%) followed by Cglahrufa (12.9%),
Cfamata (S.O%), Ckrusei (3.0%), Ciparapsilosis (1.0%), unidentified Candida species
(3.0%), Trichosporon species (3.0%) and Scerevisiae (3.0%). The percentages of
Culbicans susceptible to flucytosine (SFC), amphotericin B (AMB), fluconazole (FCA)
and itraconazole (ITR) were 94.3, 92.9, 100 and 90 respectively; that of non-albicans
isolates were 93.S, 80.6, 77.4 and 29 respectively.
There was no significant difference (p>O.OS) between the susceptibility of ('olhicans and
non-albicans isolates to SFC and AMB, however there was a significant difference
(p<O.OS) to FCA and ITR.
Cialbicans is still the predominant species causing vulvovaginal candidiasis
and demonstrates good susceptibility to all antifungal agents tested. Non-albicans yeasts
are a significant cause of vulvovaginal candidiasis and demonstrated reduced
susceptibility to all drugs, especially the azoles which are commonly used lor treatment
of vaginal candidiasis. The isolation of non-albicans yeasts may have clinical implication
given their reduced susceptibility to antifungals.
Citation
Degree of Master of Science in Medical MicrobiologyPublisher
University of Nairobi Department of Medical Microbiology
Description
A dissertation submitted in part fulfillment of the requirements of the
Masters of Science in Medical Microbiology
Department of Medical Microbiology, University of Nairobi