title: Isolation of different species of Candida in patients with vulvovaginal candidiasis from sari, iran.
abstract: BACKGROUND
  Vulvovaginal Candidiasis (VVC) is a frequent, complex and cumbersome condition that can cause physical and psychological distress for the involved individual. Candida albicans was reported as the most common agent of VVC yet it seems that we are recently encountering changes in the pattern of Candida species in VVC.
  
  
  OBJECTIVE
  In this study we assessed different species of Candida isolated from patients with VVC, residing in Sari, Iran.
  
  
  METHODS
  Two hundred and thirty-four patients with vulvovaginitis were enrolled in this study. Samples were collected by a wet swab. Each vaginal swab was examined microscopically and processed for fungal culture. The identification of Candida species was done by morphological and physiological methods such as culture on CHROMagar Candida media and sugar assimilation test with the HiCandida identification kit (HiMedia, Mumbai, India).
  
  
  RESULTS
  Out of 234 patients with vulvovaginitis, 66 (28.2%) patients showed VVC. Of these patients, 16 (24.2%) had recurrent VVC (RVVC). The age group of 20 - 29 year-olds had the highest frequency of VVC (48.5%). Erythema concomitant with itching (40.9%) was the most prevalent sign in VVC patients. Fifty-seven (86.4%) of the collected samples had positive results from both microscopic examination and culture. In total, 73 colonies of Candida spp. were isolated from 66 patients with VVC. The most common identified species of Candida were C. albicans (42.5%), C. glabrata (21.9%) and C. dubliniensis (16.4%). In patients with RVVC and patients without recurrence, C. albicans and non-albicans species of Candida were frequent species, respectively.
  
  
  CONCLUSIONS
  The results of our study showed that non-albicans species of Candida are more frequent than C. albicans in patients with VVC. This result is in line with some recent studies indicating that non-albicans species of Candida must be considered in gynecology clinics due to the reported azole resistance in these species.
authors.affiliation: Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, IR Iran ; Department of Medical Mycology and Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, IR Iran.
authors.forename: Mohammad Taghi
authors.initials: MT
authors.lastname: Hedayati
authors.affiliation: Department of Medical Mycology and Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, IR Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Taheri
authors.affiliation: Department of Gynecology, School of Medicine, Mazandaran University of Medical Sciences, Sari, IR Iran.
authors.forename: Tahereh
authors.initials: T
authors.lastname: Galinimoghadam
authors.affiliation: Department of Medical Mycology and Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, IR Iran.
authors.forename: Seyed Reza
authors.initials: SR
authors.lastname: Aghili
authors.affiliation: Department of Statistic, School of Health, Mazandaran University of Medical Sciences, Sari, IR Iran.
authors.forename: Jamshid
authors.initials: J
authors.lastname: Yazdani Cherati
authors.affiliation: Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, IR Iran.
authors.forename: Elham
authors.initials: E
authors.lastname: Mosayebi
keywords: Candida; Incidence; Vulvovaginal Candidiasis