Detection of anti-mannan antibodies and TLR9 as alternative methods for diagnosis of candidiasis in immunocompromised patients with vulvovaginitis

Vulvovaginal candidiasis is considered one of the most common women's infections. The main cause of this disease is Candida albicans, which have many virulence factors such as germ tube formation, chlamydospore, and many hydrolytic enzymes. The current study aims to use anti-mannan antibodies and TLR9 to diagnose candidiasis in immuno-compromised patients with vulvovaginitis. A total of two hundred samples were obtained from patients attending Kirkuk Tumor Center, Kirkuk, Iraq, of which 100 were vaginal swabs from immunocompromised patients aged between (18-<40 years) from the period November 2022 to March 2023. The swab samples were transported with brain-hart infusion broth (Himedia-India). Furthermore, the other 100 samples were blood samples that were separated to use the serum for the detection of TLR9 and anti-mannan antibodies. The findings indicated that Candida spp. was present in 83% of the cultured samples. A notable rise in TLR9 was observed in serum samples that tested positive for candida spp. The results of the sensitivity and specification of IgM detection using the ELISA test showed 100% and 89.4%, respectively. The same test for the detection of IgG showed 92.4% and 51.1%. The positive and negative agreement between the ELISA test for detecting IgM and the ELISA test for detecting IgG is 81.4% and 44.1%, respectively. The findings suggest that the use of anti-mannan antibodies to diagnose candidiasis should be considered and given more importance for identification purposes.