Exploring the Antifungal Drug Resistance in Candida albicans and Non-Candida albicans Isolated from Pregnant Women of Vaginal Complaints

Candidiasis associated with adverse neonatal outcomes is common in women. Therefore, the present study sought to explore the antifungal drug resistance in Candida albicans and non-Candida albicans isolated from pregnant women of vaginal complaints in Pakistan. The high vaginal swab (HVS) and urine samples from all trimesters were collected at the obstetrics and gynecology ward and processed for the isolation. The identification at the species level was determined by morpho-microscopic and biochemical characteristics. Subsequently, the resistance pattern was determined by disk diffusion assay against antifungal agents. Samples from pregnant women inclusive of 26% high vaginal discharge swabs and 74% urine samples were collected. Only the 20% (15) urine and 58% (15) HVS were positive for the isolation of candida species. By gestation period as first, second and third trimester, the sampling frequency was 19(26%), 37(50%), 18(24%), for the urine while for the HVS 11(42%), 8(31%), and 7(27%) respectively. The 83% (15) and 17% (3) isolates were confirmed as C. albicans and Non C. albicans by cultural, morpho-microscopic, and biochemical characteristics respectively. The resistance pattern confirmed that Itraconazole and Fluconazole were still effective while the isolates were highly resistant against Amphotericin B, and Voriconazole. Thus present study concludes that the Fluconazole was the drug of choice and recommended an antenatal follow-up for screening to determine the adverse neonatal outcomes in advance.