IMR Press / CEOG / Volume 51 / Issue 3 / DOI: 10.31083/j.ceog5103077
Open Access Original Research
The Prevalence of Non-albicans Candida and Candida Mixed-species in Vulvovaginal Candidiasis in Northeast Iran
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1 Department of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Sciences, 9177948564 Mashhad, Iran
2 Department of Laboratory Sciences, School of Paramedical Sciences, Mashhad University of Medical Sciences, 9177948564 Mashhad, Iran
3 Student Research Committee, Mashhad University of Medical Sciences, 9177948564 Mashhad, Iran
4 Allergy Research Center, Mashhad University of Medical Sciences, 9176699199 Mashhad, Iran
5 Sinus and Surgical Endoscopic Research Center, Mashhad University of Medical Sciences, 9176699199 Mashhad, Iran
6 Cutaneous Leishmaniasis Research Center, School of Medicine, Mashhad University of Medical Sciences, 9176699199 Mashhad, Iran
*Correspondence: Zarrinfarh@mums.ac.ir; h.zarrin@gmail.com (Hossein Zarrinfar)
These authors contributed equally.
Clin. Exp. Obstet. Gynecol. 2024, 51(3), 77; https://doi.org/10.31083/j.ceog5103077
Submitted: 6 November 2023 | Revised: 12 January 2024 | Accepted: 30 January 2024 | Published: 19 March 2024
Copyright: © 2024 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: Vulvovaginal candidiasis (VVC) is a prevalent infectious disease that affects the majority of women. While Candida albicans is the most common cause of VVC, the prevalence of non-albicans species is increasing, and mixed infections have made treatment more challenging. This study aimed to identify Candida species and detect mixed infections in women with VVC in a tropical region of northeastern Iran, employing the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Methods: In the prospective study, a total of 270 specimens of vaginal discharge were collected using sterile swabs from patients suspected of having VVC. After extracting DNA from Candida colonies, the genome was amplified using PCR with specific primers. Species identification was conducted through PCR-RFLP analysis of the ribosomal DNA internal transcribed spacer (ITS) regions, using the MspI restriction enzyme. Results: Out of the 270 specimens suspected of VVC, 167 tested positive for Candida cultures. Among these positive Candida cultures, Candida species were identified in 150 specimens, with 44 (29.3%) showing evidence of mixed Candida infections. The species of Candida in 17 specimens were not identified. Out of the 190 identified Candida isolates included, the distribution was as follows: 85 (44.8%) C. albicans, 39 (20.5%) C. glabrata, 28 (14.7%) C. guilliermondii, 11 (5.8%) C. kefyr, 11 (5.8%) C. parapsilosis, 8 (4.2%) C. tropicalis, and 8 (4.2%) C. krusei. The mixed Candida species combinations observed were as follows: C. albicans/C. guilliermondii 26 (65%), C. albicans/C. kefyr 4 (10%), C. parapsilosis/C. glabrata 4 (10%), C. parapsilosis/C. tropicalis 4 (10%), C. krusei/C. tropicalis 2 (5%), C. albicans/C. parapsilosis 1 (2.5%), C. albicans/C. krusei 1 (2.5%), C. glabrata/C. guilliermondii 1 (2.5%), and C. kefyr/C. tropicalis 1 (2.5%). Conclusions: In women with VVC in the tropical region of northeastern Iran, the prevalence of clinical non-albicans species is higher than that of C. albicans. Furthermore, there is a notable high prevalence of clinical specimens containing mixed Candida infections.

Keywords
vulvovaginal candidiasis
non-albicans Candida
women
Iran
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