Vaginal Candida spp. colonization, infection and drug susceptibility in adult women- a clinical study

Introduction: Vaginal Candida infections affect between 75-80% of women in their lifetime, with a higher prevalence in women of childbearing age. The aim of the study was to investigate vaginal yeast carriage in adult women. Methods: Vaginal swabs and smears were collected from 85 symptomatic and assymptomatic adult women 18 years and above, and analysed using Gram stain and light microscopy. Scanning electron microscopy was used to further study the morphology of the isolated Candida spp. The isolated Candida spp. were identified using chromogenic agar and PCR using Candida spp. specific primers. Drug susceptibility assays were conducted to determine their sensitivity. Results: Candida albicans and non- albicans species were isolated. Varying morphologies including host pathogen interactions between yeast and host epithelial cells were observed. Co-infections between Candida spp. and other sexually transmitted infections were also observed. Discussion: Vaginal smears provide a visual depiction of the vaginal environment at the time of sample collection, which is crucial in determining the type of infection and associated pathogens which could influence pathogenesis and disease/ treatment outcomes. Conclusion: Understanding vaginal carriage of Candida spp. and drug susceptibility provides guidance in decision making for course of treatment and management of vaginal Candida colonization and infections in adult women.