PROFILING VULVOVAGINAL CANDIDIASIS IN PREGNANCY: CLINICAL OUTCOME AND MICROBIAL LANDSCAPE IN PATIENTS ATTENDING A TERTIARY CARE CENTRE

Abstract

Vulvovaginal candidiasis (VVC) remains one of the most common fungal infections among pregnant women, attributed to hormonal and immunological changes in pregnancy that promote Candida colonization and infection.

Aim and Objectives: To assess the prevalence, species distribution, virulence characteristics, and antifungal susceptibility profiles of Candida species isolated from pregnant women presenting with symptoms of VVC.

Materials and Methods: A cross-sectional study was carried out on 250 pregnant women attending the antenatal clinic with vaginal discharge, itching, or discomfort. High vaginal swabs were collected under aseptic precautions and processed using standard microbiological methods. Species identification was done using CHROMagar and biochemical tests. Virulence factors including biofilm formation and phospholipase activity were assessed, and antifungal susceptibility was tested as per CLSI M44-A guidelines.

Results: Out of 250 samples, 128 (51.2%) were culture positive for Candida species, while 122 (48.8%) were negative. Among isolates, C. albicans constituted 48 (37.5%) and non-albicans Candida (NAC) 80 (62.5%). The predominant NAC species was C. tropicalis (66.2%), followed by C. krusei (18.7%), C. glabrata (10%), and C. parapsilosis (5%). Biofilm formation was detected in 104 isolates (81.2%), and phospholipase activity in 19 (14.8%). Resistance was highest against nystatin (88.5%) and cotrimoxazole (82.3%), while voriconazole (87.5%) and amphotericin-B (93.7%) showed the highest sensitivity.

Conclusion: Non-albicans Candida, particularly C. tropicalis, are emerging as dominant pathogens in VVC during pregnancy, showing high biofilm-forming capacity and azole resistance. Routine culture, species identification, and antifungal susceptibility testing are essential for guiding effective and safe therapy during pregnancy.