Vaginal candidiasis in Konya area: Etiology, risk factors, virulence patterns, and antifungal susceptibility

Vulvovaginal candidiasis (VVC), a common genital tract infection, is known to affect millions of women worldwide. In this study, it was aimed to determine the prevalence, virulence, possible risk factors and antifungal susceptibility model of Candida species. Vaginal swab samples were taken from patients aged 18 years and older who presented to the gynecology outpatient clinic with signs and symptoms suggestive of vulvovaginitis. Demographic data were recorded using a questionnaire. Standard microbiological methods were used for the identification of the isolates. Broth microdilution method was used to determine the antifungal susceptibility of Candida isolates. Virulence factors of Candida strains were determined by performing proteinase, phospholipase, hemolytic and biofilm activity tests. Sequencing of the isolates identified as Candida were performed using ITS 1-4 primers. Vaginal discharge (OR: 3.365; 95% CI: 1.595-7.101), burning complaint (OR: 9.098; 95% CI: 2.284-36.232) and history of allergy (OR: 3.396; 95% CI: 0.968) were risk factors. The results showed that the most common isolated strain was Candida albicans (57%). It was found that the prevalence of C. glabrata remained at 26%, 44 of the C. albicans isolates presented proteinase, 35 had phospholipase, 47 had biofilm, and 47 had hemolytic activity. In this study, susceptible dose-dependent and resistant rates of all Candida strains were found for fluconazole as 9% and 16%, respectively. Host and organism-related factors should be considered in the clinical treatment of VVC, and continuous monitoring of changes in the prevalence of Candida species and susceptibility rates is required for effective antifungal therapy.