Genotyping and Drug Resistance Profile of Clinical Isolates of Candida Albicans From Vulvovaginal Candidiasis in The Eastern China

Abstract A total of 244 Candida albicans isolates recovered from VVC patients in Suzhou, Eastern China, were investigated. According to CLSI documents M27-A4 and M59-3ed / M60-2ed, the geometric mean MICs of nine antifungals in increasing order were micafungin(0.048mg/L), anidulafungin (0.132mg/L), caspofungin (0.19mg/L), itraconazole(0.23mg/L), posaconazole(0.25mg/L), voriconazole(0.28mg/L), 5-flucytosine (0.44mg/L), amphotericin B (0.49mg/L) and fluconazole (2.01 mg/L) respectively. Of note, 6.5% (16/244) C. albicans isolates showed resistance mainly to anidulafungin (mono-echinocandin resistance), while voriconazole had the lowest susceptibility rate of 34.8% (85/244), followed by fluconazole 59.4% (145/244), respectively. All isolates were genotyped by allelic combination of 3 microsatellite markers (CEF3, CAIII and LOC4). A total of 129 different allelic genotypes were identified, in which seven different clades were recognized with a discriminatory power of 0.96. Genotype A-D were present in 35% of the isolates. In conclusion, decrease of antifungal drug susceptibility to C. albicans isolates from VVC is alarming. Our findings revealed the genetic diversity of C. albicans isolates among VVC patients and provided insights into the molecular epidemiology of Candida infections in China.