title: Antifungal Susceptibility Patterns of VulvovaginalCandidaspecies among Women Attending Antenatal Clinic at Mbarara Regional Referral Hospital, South Western Uganda.
abstract: OBJECTIVE
  To identify theCandidaspecies that cause vulvovaginal candidiasis and determine their antifungal susceptibility patterns.
  
  
  METHODS
  This was a cross-sectional study.
  
  
  METHODS
  The study was conducted at the antenatal clinic of Mbarara Regional Referral Hospital in Mbarara Municipality, between December 2012 and February 2013.
  
  
  METHODS
  High vaginal swabs from 456 pregnant women were subjected to microscopy and culture on Sabouraud Dextrose Agar.Candidaisolates were identified by the germ tube and Analytical profile index (API®Candida) tests. Susceptibility to fluconazole, itraconazole and voriconazole was determined by the Etest strips and for clotrimazole and nystatin by the disc diffusion method on Mueller Hinton agar supplemented with 2%w/v glucose and 0.5μg/ml methylene blue dye.
  
  
  RESULTS
  Of the 456 High vaginal swabs cultured, 207 grewCandida species.Species distribution was as follows:C. albicans(78.95%),C. glabrata(14.35%),C. krusei(3.35%),C. tropicalis(1.44%),C. famata(0.96%),C. parapsilosis(0.48%) andC. lusitaniae(0.48%). Resistance to nystatin was only observed in 0.61% ofC.albicans. Resistance to clotrimazole was observed in 50%, 36.67% and 0.61% ofC. famata,C. glabrataandC. albicansrespectively.C. kruseishowed a high resistance of 71.43% to fluconazole.C. glabrata,C. krusei,C. famataandC. lusitaniaeexhibited 100% resistance to itraconazole. Resistance to voriconazole of less than 11% was exhibited by onlyC. albicansandC. glabrata.
  
  
  CONCLUSIONS
  C.albicanswas susceptible to most antifungal agents tested except itraconazole and voriconazole. All isolates were susceptible to nystatin except less than 1% ofCandida albicans. Non-albicansdemonstrated resistance to some drugs especially itraconazole. We recommend use of Nystatin for empirical management of vulvovaginal candidiasis among pregnant women.
authors.affiliation: Department of Microbiology, Mbarara University of Science and Technology, Mbarara Uganda.
authors.forename: Kiguli James
authors.initials: KJ
authors.lastname: Mukasa
authors.affiliation: Department of Microbiology, Mbarara University of Science and Technology, Mbarara Uganda.
authors.forename: Itabangi
authors.initials: I
authors.lastname: Herbert
authors.affiliation: Department of Clinical Research, Epicentre Mbarara Research Centre, Mbarara, Uganda ; Department of Community Health, Mbarara University of Science and Technology, Mbarara, Uganda.
authors.forename: Atwine
authors.initials: A
authors.lastname: Daniel
authors.affiliation: Department of Microbiology, Makerere College of Health Sciences, Makerere University, Kampala, Uganda.
authors.forename: Kibuka Livingstone
authors.initials: KL
authors.lastname: Sserunkuma
authors.affiliation: Department of Microbiology, Mbarara University of Science and Technology, Mbarara Uganda.
authors.forename: Bazira
authors.initials: B
authors.lastname: Joel
authors.affiliation: Department of Microbiology, Mbarara University of Science and Technology, Mbarara Uganda.
authors.forename: Byarugaba
authors.initials: B
authors.lastname: Frederick
keywords: Antifungal; Candida species; resistant; susceptible; vulvovaginal candidiasis