Evaluation of the in Vitro Antifungal Resistance of Candida Spp. Isolated from Vulvovaginal Candidiasis in Women at Tan Tao University Hospital, Vietnam

Objective: To evaluate the in vitro antifungal susceptibility and resistance patterns of Candida spp. isolated from women with vulvovaginal candidiasis at Tan Tao University Hospital, Vietnam in 2024. Methods: A cross-sectional study was conducted on 270 women clinically diagnosed with vaginitis. Vaginal discharge samples were examined by direct wet mount, cultured on Sabouraud Dextrose Chloramphenicol Agar, and species identification was performed using real-time PCR. Antifungal susceptibility testing was carried out by broth microdilution and disk diffusion methods according to CLSI guidelines (M27-A3, M60). Tested antifungal agents included amphotericin B, micafungin, caspofungin, ketoconazole, miconazole, itraconazole, fluconazole, posaconazole, voriconazole and nystatin. Results: Among the 43 isolates, Candida albicans was the predominant species (72.1%), followed by C. parapsilosis (25.6%), C. glabrata (16.2%) and C. tropicalis (2.3%). The isolates exhibited high susceptibility to most tested antifungal agents. Sensitivity rates were 100% for micafungin, caspofungin, posaconazole, and nystatin; 97.67% for amphotericin B and voriconazole; 95.35% for itraconazole; 93.02% for fluconazole; 88.37% for ketoconazole; and 81.49% for miconazole. Conclusion: The study indicates an increasing trend of antifungal resistance, particularly among azole agents. Routine species identification and antifungal susceptibility testing are essential for optimizing treatment regimens and reducing the risk of therapeutic failure.