Abstract

The objective of this study is to determine the susceptibility profile of different Candida strains isolated from vulvovaginal candidiasis and identified by MALDI-TOF MS, using the AST-YS08 Card with Vitek 2. The AST-YS08 card with Vitek 2 was used to test the antifungal susceptibility of 38 clinical isolates of Candida recovered from vulvovaginal swabs throughout the period 2017 to 2018. The study included Candida albicans (n = 28), Candida tropicalis (n = 6), Candida glabrata (n = 3) and Candida parapsilosis (n = 1), previously identified by MALDI-TOF MS. As antifungals, polyenes (amphotericin B, AMB), azoles (fluconazole FLC and voriconazole VRC) and echinocandins (caspofungin CPF and micafungin MCF) were tested. All isolates of C. tropicalis, C. glabrata and C. parapsilosis were sensitive to FLC, VRC, CPF, MCF and AMB as well as for 100% of C. albicans isolates to FLC, CPF, MCF and AMB. However, 5% (n = 2) of C. albicans isolates showed resistance to VRC with MIC values four and eight times higher than for C. albicans breakpoint, respectively. Feasible and easy germ tube test detection of VVC strains showed a very high sensitivity (100%) but with specificity 80% judged by MALDI-TOF MS. Decreased susceptibility to VRC remains a little worrying since this molecule constitutes currently a recourse in case of resistance to FLC.

Key words: Antifungal susceptibility, Candida, vulvovaginal candidiasis, AST-YS08 card, Vitek 2, MALDI-TOF MS, Dakar.