A study on the prevalence, isolation and sensitivity pattern of genital candida species in female patients attending STD outpatient department

Shanmuga Priya, K (2016) A study on the prevalence, isolation and sensitivity pattern of genital candida species in female patients attending STD outpatient department. Masters thesis, Madras Medical College, Chennai.

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Abstract

Vulvovaginal candidiasis is an infection and inflammation of the female external genitalia caused by Candida species. The prevalence of Vulvovaginal candidiasis (VVC) is increasing due to the extensive utilization of broad-spectrum antibiotics as well as increased incidence of immune compromised states and diabetes. There has been a significant trend towards the emergence of other species such as C. glabrata, identification of which has prognostic and therapeutic significance. AIMS AND OBJECTIVES : 1. To study the prevalence of various Candida species in female patients with vaginal discharge. 2. To study the susceptibility pattern of Candida to commonly used antifungals. MATERIALS AND METHODS : It is a Prospective observational study of 200 female patients attending the STD OPD with or without symptoms. Patients aged <18 yrs and >60 yrs, pregnant, lactating & menstruating women, those not willing to participate in the study and those who had used antifungals within past 7 days were excluded. A detailed history was taken and complete genital examination was done. A sample of vaginal discharge was collected. Microscopic examination with Gram’s stain and KOH and culture with Sabouraud’s Dextrose Agar was done. Speciation was done using Chromogenic agar. Antifungal susceptibility was tested by disk diffusion method. OBSERVATION AND RESULTS : The prevalence of Vulvovaginal Candidiasis proven by either culture or microscopy was 29%. Only 7% patients had pseudohyphae and spores on microscopic examination. Of the asymptomatic patients, 28.3% had VVC. C.glabrata (61.22%) was the most common species isolated followed by C.albicans (20.4%). Nystatin was the most effective antifungal (81.63%) followed by Miconazole and Fluconazole. CONCLUSION : This study shows that if microscopy, which is the commonly used bedside test to confirm Candidiasis, alone is used for diagnosis, most of the VVC cases would be missed. Culture has significantly increased the detection of VVC cases. Culture and microscopy used in combination would be better than either tests used alone. This study has also proven the importance of considering Candida species other than C. albicans and drug resistance to first line antifungals as a cause of treatment failure.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Vulvovaginal Candidiasis ; Antifungals ; CHROM Agar ; C.glabrata.
Subjects: MEDICAL > Dermatology Venereology and Leprosy
Depositing User: Punitha K
Date Deposited: 27 Jul 2017 09:26
Last Modified: 01 Mar 2018 02:28
URI: http://repository-tnmgrmu.ac.in/id/eprint/2237

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