Vulvovaginal Candidiasis Among Patients Attending the Gynecology Outpatient Department (GOPD) and STD Clinic With Special Reference to Their Antifungal Susceptibility and the Genetic Diversity of Non-albicans Candida in a Tertiary Care Hospital

Background Vulvovaginal candidiasis (VVC) is a common opportunistic infection worldwide. This study, undertaken at a tertiary care center in North-East India, aimed to assess VVC among clinically suspected cases. The study also determined the epidemiological distribution of the associated Candida species (spp.), along with an evaluation of their antifungal susceptibility patterns. Methods Specimens from 300 clinically suspected cases of VVC were subjected to phenotypic and molecular identification methods, along with antifungal susceptibility testing by disk diffusion test and minimum inhibitory concentration (MIC) determination. Results Ninety-six cases (32%) showed the growth of Candida species. The mean age of culture-positive cases was 29.6 years. VVC was found to be more common among married women (85.42%) than in unmarried women (13.54%). Candida albicans (C. albicans) was the predominant pathogen, accounting for 75% (n = 72) of the total isolates, and the rest (25%, n = 24) were non-albicans Candida (NAC) species, dominated by C. tropicalis (15.63%) and followed by C. glabrata (4.17%), Pichia kudriavzevii (P. kudriavzevii) (3.13%), and C. parapsilosis (2.08%). A high degree of drug resistance was seen to most of the azoles, especially fluconazole. Voriconazole displayed a lower degree of resistance, besides nystatin and amphotericin B, and can thus be used with confidence for the treatment of VVC in this region. Conclusion Though Candida albicans is the predominant species, non-albicans Candida, such as Candida tropicalis and Candida glabrata, are being increasingly reported in VVC, showing high resistance to azole antifungals. The prompt identification of Candida isolates and the determination of antifungal sensitivity patterns will help to improve treatment outcomes for VVC.