Biofilm Production And Antifungal Resistance Among Candida Species In Patients With Vulvovaginitis: A Cross Sectional Study

Abstract

Background: Vulvovaginal candidiasis (VVC), one of the commonest fungal infections in women of
reproductive age group, can become recurrent if not managed appropriately. Recently, production of
biofilm, which reduces the susceptibility to anti-fungal agents, has also been implicated in its pathogenesis.
Hence, the study was planned to determine the prevalence of VVC in cases of vulvovaginitis, identify the
pre-dominant candida species, and find out their antifungal susceptibility pattern and to detect biofilm
production in the candida isolates. Material And Methods: In this cross-sectional study, all isolates were
identified and confirmed by various basic microbiological methods followed by the VITEK-2 system. Biofilm
formation was detected by Congo red agar method and Tube method. Descriptive statistical methods were
used to evaluate the data collected. Result: Out of total 25 patients, 7 were positive with VVC out of which
2 cases were caused by C.albicans and 5 by Candida Non Albicans (3 by C.glabrata and 2 by C.tropicalis). As
compared to NAC, C. albicans is still partially sensitive to fluconazole. Fortunately, both C. albicans and C.
tropicalis are still 100% sensitive to voriconazole although resistance has developed partially in C. glabrata.
Biofilm production was observed in 3 cases. Conclusion: Majority of cases of VVC were due to NAC
predominantly C. glabrata which has grave therapeutic implications as they show decreased susceptibility
to all antifungals. Voriconazole is still effective but needs to be used rationally to avoid developing
resistance to it also. The evidence of biofilm production could be an important contributor towards
increased incidence of antifungal drug resistance. [Garg A Natl J Integr Res Med, 2024; 15(1): 19-25,
Published on Dated: 26/01/2024]