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Background  Vulvovaginal candidiasis (VVC) represents a universal health hazard that contributes to significant morbidity in women. Resistance of  Candida  to antifungal therapy has been reported as a public health problem. So, the objective of our current study is to detect resistance profile of different candidal strains.    Methods  In this study, isolated  Candida  strains were identified by conventional methods, confirmed by internal transcribed spacer (ITS) sequencing, and phylogenetically analyzed with reference strains in GenBank. Also, sensitivity of different Candida strains to common antifungal agents was evaluated by disc diffusion method.    Results   Candida albicans  was identified as the most frequent strain (63%) followed by non- albicans  strains, such as  C. glabrata  (20%),  C. tropicalis  (13%), and  C. krusei  (4%). Sensitivity of  Candida  strains ( C. albicans ,  C. tropicalis  and  C. glabrata ) to commonly used antifungal agents was evaluated through the disc diffusion method.  C. glabrata  was the most resistant strain and considered to be a multidrug-resistant pathogen, while both,  C. albicans  and  C. tropicalis  showed high susceptibility to terbinafine. In contrast,  C. albicans  showed resistance to fluconazole, clotrimazole, and nystatin, while  C. tropicalis,  considered as the most sensitive strain, was susceptible to all the antifungal agents tested except nystatin. Terbinafine was the most effective antifungal agent against both  C. tropicalis  and  C. albicans,  and hence its minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) for  C. albicans  and  C. tropicalis  were evaluated. MICs of terbinafine against  C. albicans  and  C. tropicalis  were 5 μg/ml and 2.5 μg/ml, while their MFCs were 10 μg/ml and 5 μg/ml, respectively.    Conclusion  The emergence of resistant  Candida  strains necessitates conduction of the antifungal susceptibility test prior to deciding the medication regime.

In vitro antifungal resistance profile of Candida strains isolated from Saudi women suffering from vulvovaginitis