PECULIARITIES OF SENSITIVITY TO THE ANTIMICOTICS OF CANDIDA STRAINS, ISOLATED FROM WOMEN WITH LESIONS OF REPRODUCTIVE TRACT

Tkachenko M. A., Sklyar T. V.

MICROBIOLOGY

Scentific article

Vulvovaginal candidiasis take an one of the first places in the structure of infectious and inflammatory diseases of female genital organs. It is known that among the infections of the lower departments of the sexual system up to 50% of the cases of lesions is caused by Candida. Candidiasis refers to opportunistic mycoses, that is, they are caused by opportunistic fungi. According to modern notions, the specified disease does not refer to sexually transmitted group, but nevertheless the peak of incidence occurs at the beginning of sexual activity and the years of the greatest reproductive activity of women. The aim of the research was to study the species range of fungi of genus Candida, isolated from the genital tract of women with complaints, and to investigate their sensitivity to antimycotics. The biological material from women (secreted vaginal mucosa) with lesions of the genital tract, whose etiology had to be established, was investigated. The study of the material involved microscopic stage and inoculation of microorganisms on the nutrient medium in order to identify by the results of physiological and biochemical tests. For all isolated strains of fungi, determination of sensitivity to antimycotic drugs was done. Based on the results of microscopic analysis of 49 samples of biological material from women, the presence of yeast-like fungi of the genus Candida in 36 samples of material was determined, which was 73.5%. It should be noted that the representatives of the genus Candida were not the only ones that occurred in the samples: most often on the smears were mixed cultures. Candida monoculture was detected only for 5 (13.9%) samples. Microscopic analysis allowed to determine the number of cases of infectious process and Candida carriage. Consequently, the incidence of detection of candidiasis carriage – 27 cases (75%) significantly exceeded the frequency of detection of active infection of 9 cases (25%). Identification of Candida isolates were done on ChromID medium. Among the pathogens of candidiasis, the most frequent were C. albicans – 10 cases (27.8%), C. tropicalis – 8 cases (22.2%), C. krusei and C. glabrata – in 7 cases (19.4%) and Candida spp. – 4 cases (11.1%). The study of sensitivity to antimicotic drugs made it possible to establish that most of the isolates were sensitive to all the drugs used. The exception was C. krusei, which has natural resistance to fluconazole. It was found that the percentage of sensitive isolates with the exception of nystatin is quite high (more than 70%). The exception is the only drug – nystatin, the fate of sensitive fungi to which does not reach 63%. The most cases of resistance fixed for isolates of C. glabrata – 57.1%, less among C. tropicalis – 37.5%. All isolates were the most sensitive to amphotericin B – more than 87.5%, but this antimycotic is not used in gynecology. Clotrimazole was second in place, to which more than 75% of the isolates were susceptible, which is mainly used for the treatment of skin lesions. Therefore, itraconazole and ketoconazoleto which more than 71% of isolates were sensitive, were recommended for treatment. The drug fluconazole showed somewhat less efficacy, however, in most cases its use also remained possible. Vulvovaginal candidiasis is one of the most common pathologies of the female reproductive system, which has significant consequences, including violations of the composition of the microflora, and the loss of pregnancy, as well as infertility. Therefore, one of the determining issues is the choice of an optimal therapeutic regimen, which includes the choice of antimycotic drug to which the isolate of the fungus is susceptible. Keep in mind the prevalence of resistance forms to therapeutic drugs among clinically relevant microorganisms, it is necessary to continuously monitor their sensitivity to improve treatment regimens.

vulvovaginal candidiasis, candida, identification, frequency of determination, sensitivity to antimicoticics

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«Bulletin of problems biology and medicine» Issue 4 Part 3 (141), 2017 year, 277-281 pages, index UDK 579.61+616.618.16-022.181-092

10.29254/2077–4214–2017–4–3–141–277-281