Etiologia da candidíase vulvovaginal e perfil de susceptibilidade aos antifúngicos de Candida albicans e Candida tropicalis isoladas de secreção vaginal de mulheres com idade reprodutiva na cidade de Maputo

Abstract

Vulvovaginal candidiasis (VVC) is a global problem and the second most common cause of second most common cause of vaginitis in women (after bacterial vaginosis). This infection is mostly caused by strains of the Candida genus, and three quarters of women of reproductive age have at least one episode of vulvovaginal candidiasis. The prevalence of this infection and the antifungal susceptibility profile of Candida species have shown variation over time and space. Surveillance studies on vulvovaginal candidiasis are scarce in Mozambique, especially those studies that include data from private laboratories, making it difficult to monitor laboratories, making it difficult to control and treat infections. Objective: To determine the frequency and antifungal susceptibility profile of C. albicans and C. tropicalis isolated from women of reproductive age at the Joaquim Chaves Clinical Analyses Laboratory between February and April 2023. This was a descriptive cross-sectional study with a retrospective approach. approach in which 369 samples of vaginal exudates collected from women with suspected vulvovaginal candidiasis at the Joaquim Chaves Laboratory in Mozambique were included. The samples were cultured on Sabouraund Gentamicin and Chloramphenicol Agar media for the isolation and preliminary identification of C. albicans and C. tropicalis species. Confirmation of species identification was made using chromID Candida chromogenic medium and the isolates were subsequently inoculated onto Skim milk for preservation in a -80°C refrigerator, making up the biobank of the UEM Microbiology Laboratory. The antifungal susceptibility tests were carried out on Agarsabouraund dextrose culture medium, including three antifungals, fluconazole (25μg), clotrimazole (50mcg) and nystatin (100IU), using the disc-diffusion method and the results were interpreted according to the CLSI Clinical and Laboratory Standards Institute guidelines. Of the total of 369 vaginal exudate samples, only 150 samples (100 per cent) were included in this study. only 150 samples (100%) were included in this study, with 138 (92%) positive for C. albicans and (8%) 12 positive for C. tropicalis. The antifungal susceptibility profile of C. albicans showed an increasing frequency of resistance to the antifungal fluconazole 38/138 (28%) and sensitivity 83/138 (60%), 53/90 (58.8%) sensitivity to clotrimazole. The C. tropicalis isolates showed high resistance rates to nystatin 12/12 (100%) and fluconazole 8/12 (67%). The study shows that all isolates of C. albicans and C. tropicalis were resistant to nystatin. Isolates of C. albicans and C. tropicalis showed greater sensitivity to clotrimazole, followed by fluconazole, which suggests its efficacy in treating these infections. We observed a high prevalence of vulvovaginal candidiasis in Candida albicans was the most prevalent agent of vulvovaginal candidiasis in this study; C. albicans showed high rates of sensitivity to clotrimazole, followed by fluconazole. However, C. albicans and C. tropicalis showed resistance rates to nystatin of 100 per cent. (TRADUÇAO NOSSA)