Antifungal susceptibility of Candida by disc diffusion method of isolates from clinical cases of vulvovaginitis of a tertiary care hospital in Mumbai

Background: Vulvovaginal Candidiasis (VVC) is a grave public health problem affecting young and middle-aged females especially during their reproductive life. Though Candida albicans is the commonest species involved, recurrent episodes of VVC are caused by non-albicans Candida (NAC) spp. The NAC spp also show resistance to commonly used antifungal drugs leading to recurrent infections, complications and treatment failure. In addition, widespread use and over the counter availability of antifungals leads to resistance. Therefore, antifungal susceptibility testing of Candida isolates is mandatory for selection of an appropriate and accurate antifungal therapeutic agent Objectives: To perform in vitro antifungal susceptibility testing by disc diffusion method. Materials and Methods: A total of 150 vaginal Candida isolates were used to perform Antifungal susceptibility test by disc diffusion method. Mueller Hinton Agar with 2% Glucose and 0.5 μg/mL Methylene Blue Dye medium and six antifungal drugs Amphotericin B, Fluconazole, Itraconazole, Ketoconazole, Clotrimazole and Nystatin were used. Results were calculated using CLSI M 44-A2 (S3) for fluconazole and standard reference articles for other drugs. Results and Conclusion: Susceptibility of Candida albicans was 100% to Amphotericin B, Nystatin and 97.2% to Ketoconazole. NAC spp were less susceptible to Fluconazole and Clotrimazole as compared to Candida albicans. Resistance was found even to Amphotericin B and Nystatin among NAC spp. Accurate and reliable antifungal susceptibility testing is necessary to help the clinicians in better patient management and preventing the emerging antifungal resistance