IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 20, Issue 9 Ser.4 (September. 2021), PP 47-52 www.iosrjournals.org DOI: 10.9790/0853-2009044752 www.iosrjournal.org 47 | Page Species distribution and antifungal susceptibility pattern Candida species isolated from patients with vulvovaginal candidiasis by Vitek 2 compact system, in Western Maharashtra. Dr. Deepa Devhare* Assistant professor Department of Microbiology Bharati Vidyapeeth Medical College, Pune. Abstract: Background: Vulvovaginal candidiasis (VVC) is the most common cause of fungal infection in reproductive age group. It is of special concern due to its chronic course and frequent recurrence due to inappropriate or incomplete treatment. Due to emergence of antifungal drug resistance, traditional practice of empirical treatment does not work in all patients. With this background present study was conducted to determine the prevalence, species distribution and antifungal susceptibility pattern of Candida species causing VVC. Material and methods: 241 vaginal swabs were collected from clinically suspected cases of VVC. Speciation and antifungal susceptibility testing (AFST) was performed using fully automated Vitek 2 compact system. Results: Prevalence of VVC in present study was found to be 12 %( 29/241). Candida albicans was the most common Candida species isolated from from VVC. Other species isolated were C. lusitaniae, C. glabrata and C.parapsilosis. Candida albicans showed 100% sensitivity for caspofungin and micafungin followed by 96% sensitivity to amphotericin B and fluconazole. C. albicans as well as and Non albicans candida showed 17.4% reduced sensitivity to voriconazole. Conclusion: Local data about the most common pathogens causing VVC and their antifungal susceptibility pattern should be available for clinicians to decide appropriate therapy for patient. With increasing need for antifungal susceptibility testing, Vitek 2 compact acts as rapid and accurate tool. Keywords: Vulvovaginal candidiasis, AFST, Vitek 2 compact, automation, C.albicans, non-albicans candida -------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 25-08-2021 Date of Acceptance: 09-09-2021 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Candida belongs to the commensal flora in oral cavity, skin and genitourinary tract in humans. In susceptible hosts it acts as opportunistic pathogens. It is a leading etiological agent of fungal infections in human beings. Candida species causes variety of human infections ranging from cutaneous infections to life threatening systemic infection.[1] The most common clinical manifestation of candidiasis is vulvovaginal candidiasis (VVC) which is a sexually transmitted disease in females specifically in reproductive age group.[2] Candida species are broadly divided in to two groups namely Candida albicans and nonalbicans Candida species. Candida albicans is the most common among all species of Candida causing vaginitis.[3] About 50- 70% women worldwide are affected by vulvovaginal candidiasis, and about 40% of them have recurrent episodes.[4,5] In few patients (5%), vulvovaginal candidiasis becomes refractory to treatment and takes chronic course.[6,7] Occurrence of vulvovaginal candidiasis is commonly associated with predisposing factors like socio demographic factors, personal hygiene, sexual activity, diabetes mellitus, oral contraceptive pills, immunosuppression, and hormonal changes as seen in pregnancy. [8, 9] Increased incidence of vulvovaginal candidiasis is observed with increased use of antibiotics. Antibiotics eliminate the vaginal lactobacilli which are healthy bacteria protecting the vaginal epithelium. As result of this Candida species can adhere more to the vaginal mucosa and there is increased growth and colonization of this organism in the genital tract leading to infection. [8, 10] Fluconazole, voriconazole, nystatin, ketoconazole, caspofungin, clotrimazole, flucytocine are the different antifungal agents used for treatment of candidiasis. Empirical treatment for vulvovaginal candidiasis essentially involves antifungals, mainly azoles. Diagnosis and treatment of VVC is done mainly based on clinical findings. Treatment based on microbial culture and other laboratory based tests is still low. Due to such