International Journal of Biomedical And Advance Research ISSN: 2229-3809 (Online) Journal DOI:10.7439/ijbar CODEN:IJBABN IJBAR (2014) 05 (12) www.ssjournals.com Research Article Biofilm formation among Candida albicans isolated from vagina D C Thamke 1 , H A Tayade 2 , S A Tayade *3 , N. J. Bankar 1 and N.G. Rathod 1 1 Department of Microbiology, Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra, India 2 Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra, India 3 Obstetrics and Gynecology, Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra, India *Correspondence Info: Dr. Surekha Tayade, E/4, Senior Staff Quarters, KHS Campus, MGIMS, Sewagram, Wardha, Maharashtra, India, 442102 E-mail: surekhatayademgims@yahoo.co.in 1. Introduction In women of reproductive age group, Candida albicans can be present as colonizer in (17% to 30%) or is the leading cause of vulvovaginal candidiasis (VVC) in (85-90%) 1 of cases which will affect 75% of all women at least once in their lifetime and about 5-8% of women experience recurrent VVC 2 . Among many cases of vaginitis, VVC is the second most common after bacterial vaginosis and diagnosed in up to 40% of women with vaginal complaints in primary care setting. In United States only, vaginitis related health care costs are estimated at $1.8 billion annually. 3 Therefore, it is important to understand fungal factors that contribute to its immunopathology. Several properties of candida albicans have been proposed to play major roles in causing disease and include morphogenesis, secreted aspartyl Proteinases (SAPs) and biofilm formation. 1 These traits may facilitate asymptomatic colonization or symptomatic infection 1 . Candida albicans secreted aspartyl proteinases( SAP) has been extensively reviewed. 4 and showed that candida albicans isolated from symptomatic patients with vaginal candidiasis are significantly more proteolytic than isolates from asymptomatic vaginal carriers. 4 Candida albicans has ability to form biofilms on biotic and abiotic surfaces. Biofilms confer properties of increased adhesion, recalcitrance to clearance by the host immune system and enhanced antimicrobial resistance 5 . Studies have demonstrated wide variations in biofilm formation among candida albicans causing invasive and non invasive infections and among natural populations isolated from oral cavity, environment and vagina of candidiasis patients. 6,7 Therefore, this study was undertaken to investigate in vitro biofilm forming abilities of Candida albicans isolated from patients of VVC(cases) and asymptomatic carriers(controls). 2. Material and Methods The present study was conducted in the Department of Microbiology and Obstetrics and Gynecology at Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra, a rural tertiary care hospital in central India in May and June 2014. The study was commenced after the approval of Institutional Ethical Committee. Informed consent of the patients was taken in local language in the prescribed format, before registering them in the study. 2.1 Study Subjects Women attending Gynaecology and Obstetrics outpatient unit of Kasturba Hospital of Mahatma Gandhi Institute of Medical Sciences, Sewagram 2.2 Study population Women with clinically diagnosed vulvovaginal candidiasis were registered as cases and healthy women not having vulvovaginal candidiasis were consequently registered as controls in the study. A total of 100 subjects were included (cases: 50 and controls: 50). Inclusion criteria for cases of VVC were married women of all age groups, attending Gynaecology clinic with complaints of white discharge per vaginum, clinically on per speculum examination presence of curdy white discharge and women consenting for vaginal swab and for controls criteria were women not complaining of white discharge per vaginum and not having clinical VVC but attending gynaecological outpatient unit for any other complaint such as routine antenatal care. Women with clinically diagnosed vulvovaginal candidiasis on antifungal treatment were excluded. Abstract Purpose: Study was conducted in a rural tertiary care hospital with a purpose to demonstrate the biofilm forming abilities of C. albicans isolated from cases of vulvovaginal candidiasis and asymptomatic carriers. Material and Methods: C. albicans was isolated and identified by standard laboratory techniques. Biofilm formation in vitro was tested using the 96 well microtitre plate method with crystal violet staining. Results: Overall rate of Candida isolation in study subjects was 40%. Candida isolation in cases was 56% and that of controls was 24%. C. albicans was the predominant species in cases and controls (71.45% and 91.67%). Biofilm formation was seen in 40% versus 27.27% in cases and controls. Conclusion: C. albicans isolated from cases and controls demonstrated similar biofilm forming abilities. Other virulence factors may be more significant than biofilm formation in pathogenesis of VVC. Further studies are needed to investigate the issue on larger sample size. Keywords: Candida albicans, Biofilm formation, Vulvovaginal candidiasis