Species Distribution, Characterization, and Antifungal Susceptibility Patterns of Candida Isolates Causing Oral and Vulvovaginal Candidiasis in Chile

Background: Oral candidiasis (OC) and vulvovaginal candidiasis (VVC) are infections caused by species belonging to the genus <i>Candida</i>. In Chile, epidemiological studies on OC/VVC are scarce, leading to an overestimation of the prevalence of <i>C. albicans</i>. Additionally, awareness of the prevalence of species phenotypically and genotypically similar to <i>C. albicans</i> is lacking. The clinical impact of non-albicans species in cases of OC/VVC is also often underestimated. This study aims to determine the distribution of <i>Candida</i> species, their phenotypic and molecular characteristics, and their antifungal susceptibility patterns in incidents of oral and vulvovaginal candidiasis in Chile. Methods: A descriptive analysis was conducted on 101 isolates of <i>Candida</i> spp. obtained from OC/VVC cases. The identification of <i>Candida</i> species was performed using both phenotypic and molecular techniques. Antifungal susceptibility testing was carried out using the Sensititre YeastOne system. Results: Among the analyzed isolates, 89.1% were identified as <i>C. albicans</i>, while 10.9% were categorized as non-albicans species, including <i>C. dubliniensis</i>, <i>C. glabrata sensu stricto</i>, <i>C. bracarensis</i>, <i>C. tropicalis</i>, <i>C. lusitaniae</i>, and <i>C. parapsilosis sensu stricto</i>. The susceptibility pattern was predominantly susceptible, with only 10.9% of the total strains demonstrating resistance, and low antifungal activity in vitro was observed for Fluconazole, Voriconazole, and Posaconazole. Conclusions: The most prevalent species causing OC/VVC in Chile is <i>C. albicans</i>. This study also presents the first report of <i>C. lusitaniae</i> as a causal agent of VVC in the country. The identification of azole-resistant strains emphasizes the critical role of laboratory diagnosis in VVC cases, thereby preventing potential treatment failures. No resistance was observed in the strains associated with OC.

Abstract licence: CC BY

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