Analysis of the prevalence and sensitivity to antimycotic drugs of C. albicans strains in Bukovina during 2019–2023
DOI:
https://doi.org/10.14739/2310-1210.2025.2.318170Keywords:
Candida albicans, spreading, resistance, anti-fungal agents, polyenes, azoles, COVID-19 pandemicAbstract
The aim of this work was to study the prevalence of C. albicans strains among patients with inflammatory processes of various localization during 2019–2023 years and to analyze dynamics in the sensitivity of these isolates to antifungal drugs.
Materials and methods. The study examined 608 strains of C. albicans: 161 strains isolated from the vaginal mucosa, 170 isolates – from the oral mucosa and tonsils, and 276 strains isolated from feces. A chromogenic medium was used for primary culture isolation, identification, and differentiation of Candida ssp. The sensitivity of all isolated strains to antifungal drugs (nystatin, amphotericin B, fluconazole, voriconazole, itraconazole, clotrimazole, econazole, miconazole, ketoconazole) was determined by the disk diffusion method according to the 2017 recommendations of the Clinical and Laboratory Standards Institute (CLSI).
Results. The incidence of C. albicans isolation from all studied biotopes had been increasing until 2022, whereas the number of isolations was statistically significantly higher in 2020 year compared to that in 2019 year: for strains isolated from the oral mucosa tφ = 1.67, p < 0.05; for vaginal isolates tφ = 2.66, p < 0.01; for fecal tφ = 2.76, p < 0.01. A statistically significant decrease in the isolation of C. albicans from all analyzed biotopes was noted in 2023. The dynamics of the isolated C. albicans strain sensitivity was barely related to the biotope of pathogen isolation. Among all the strains studied, sensitivity to nystatin remained high throughout the entire observation period, while it decreased to amphotericin B in 2020 (statistically significantly for vaginal isolates, tφ = 2.73, p < 0.01). The sensitivity of C. albicans strains to fluconazole and voriconazole was almost unchanged and did not relate to the biotope of pathogen isolation. Susceptibility to itraconazole was higher among all the strains (statistically significantly when comparing the data of 2021 and 2022: for oral strains tφ = 7.63 (p < 0.001); for vaginal tφ = 4.85 (p < 0.001); for fecal tφ = 7.97 (p < 0.001). The susceptibility of isolated C. albicans strains to clotrimazole, econazole, and ketoconazole was sharply decreased in 2020 with the onset of the SARS-CoV-2 pandemic (COVID-19), statistically significantly in most cases, and gradually increased to pre-epidemic levels in the years that followed.
Conclusions. The increase in the incidence of C. albicans isolation in 2020–2022 can be considered a trend for the initial period of the COVID-19 pandemic. At the same time, a substantial decrease, often statistically significant, in the isolated strain sensitivity to clotrimazole, econazole, ketoconazole and a gradual increase in this indicator the following year have been detected. The highest and almost constant sensitivity of the studied C. albicans strains was to nystatin, voriconazole, fluconazole, and it was the lowest to miconazole. Changes in the sensitivity of C. albicans strains to antifungal drugs require constant monitoring of this parameter.
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