Species Distribution And Antifungal Susceptibility Profile Of Causative Agents Of Vulvovaginal Candidiasis And Molecular Identificatin Of Candida Africana

Part one:Species Distribution and Antifungal Susceptibility Profile of Causative Agents of Vulvovaginal CandidiasisVulvovaginal candidiasis?VVC?is a very common disease,whose causative Agents includes Candida albicans?Candida glabrata?Candida krusei?Candida parapsilosis?Candida tropicalis etc.There were some reports on reduced susceptibility of Candida isolates from vulvovaginal candidiasis to common antifungal agents,however,little information is available regarding the species distribution and antifungal susceptibility profile of causative agents of vulvovaginal candidiasis in western China—Xinjiang.Our research identified 236 Candida isolates from VVC patients in Xinjiang and investigated their antifungal susceptibility to 11 antifungal agents?including three echinocandins and three new triazoles?according to M7-A3 protocol.207 Candida albicans isolates?18Candida glabrata isolates?9 Candida krusei isolates?1 Candida parapsilosis isolate and 1Candida tropicalis isolate were found.Candida albicans isolates from Xinjiang were susceptible to three echinocandins while micafungin and anidulafungin had lower MIC values than those of caspofungin;they showed good susceptibility to Amphotericin B and flucytosine;most of them were sensitive to fluconazole whereas itraconazole and voriconazole had reduced activity to half of the Candida albicans isolates and higher rate of resistance to voriconazole was found;they were susceptible to three new triazoles but the susceptibility was less than that of Candida albicans isolates causing invasive infections;and there were some Candida albicans isolates cross-resistant to triazoles.Candida glabrata isolates and Candida krusei isolates from Xinjiang had good susceptibility to echinocandins except caspofungin;they also reacted well to Amphotericin B?flucytosine and new triazoles while they performed inactively to fluconazole and itraconazole;when it comes to voriconazole,Candida krusei isolates showed good susceptibility and MIC_50/90 against Candida glabrata isolates were0.5/1 ug/ml.The sole Candida parapsilosis isolate was susceptible to all antifungal agents but the sole Candida tropicalis isolate had reduced susceptibility to caspofungin and itraconazole and resistance to fluconazole and voriconazole.Part two:Molecular Identification of Candida africanaCandida africana is a new species or variety within the Candida albicans complex.It produces a germ tube but not chlamydospores and doesn't have the ability to assimilate the glucosamine?trehalose?DL-lactate and N-acetylglucosamine.It is difficult to discriminate this pathogen from Candida albicans complex in clinical laboratories.It has natural tendency to infect or colonize the genital mucosa of women and its distribution appears to be worldwide,but there is a poor understanding of its epidemiology and genetics and more investigation is needed.In the present study,four Candida africana isolates were identified successfully by using HWP1 gene PCR and the MLST results showed three Candida africana isolates shared the unique sequence type of Asia—ST 782 and the remaining one isolate shared a new sequence type?ST 3432 named by MLST Database?.All Candida africana isolates were susceptible to 11 antifungal agents tested.