Background: Vulvovaginal candidiasis (VVC) is a common fungal infection caused mainly by Candida albicans. This study aimed to determine the genotypes and subtypes of C. albicans responsible for VVC and to assess their susceptibility to fluconazole. Methods: A total of 103 females referred to the Laboratory of Parasitology at the Military Hospital of Tunis for vaginal sampling were included. C. albicans isolates were identified using phenotypic and molecular methods. Genotyping and subtyping were performed using 25S rDNA–based and ALT-RPS–based primers, respectively. The susceptibility to fluconazole using E-test technique was made for 60 strains. Results: Genotype B was the most prevalent (46%), predominantly subtype B2/3/4 (51%), followed by genotype A (34%) with subtype A2/3/4 (49%), and genotype C (20%) with a single subtype C3. The mean age of patients was 31 years (range: 13–74). The most common clinical sign was white leucorrhea, observed in 80% of cases. Significant correlations were found between genotypes and age group, pregnancy status, trimester, clinical signs, and culture abundance (p < 0.05). Additionally, sub-genotype distribution was significantly associated with pregnancy, parity, and trimester (p < 0.05). Fluconazole susceptibility testing revealed that 57% of strains were resistant. Conclusion: This study identified three major C. albicans genotypes (A, B, and C) and ten RPS subtypes among Tunisian VVC isolates. A high rate of fluconazole resistance was observed, highlighting the need for antifungal susceptibility testing to guide effective treatment.
Latifa et al. (Sat,) studied this question.