Evaluation of susceptibility to antifungal agents of fungal strains isolated from pregnant women with diabetes and healthy pregnant women

Abstract

Abstract Objectives: An increase in the frequency of fungal infections is related with progress in mycology and decreased susceptibility of fungal strains to commonly used antifungal agents. Diabetes and pregnancy are two independent factors believed to be responsible for an increased risk of mycoses. The aim: The aim of the study was to assess the susceptibility of fungal strains isolated from pregnant women with diabetes as well as healthy pregnant women to ten antifungal agents. Material and methods: In the study 106 diabetic pregnant women and 102 healthy pregnant women were included. Susceptibility of the fungal strains was assessed in vitro by disk diffusion test. Results: Fungal strains were detected in 190 (30.4%) out of 624 samples obtained from vagina, rectum and oral cavity of 208 women. Fungi were found in 42.1% of pregnant women with diabetes and in 41.5% of health pregnant patients. Strains isolated from the diabetic women showed the highest susceptibility to pimaricin (34.4%), nystatin (31.3%) and tioconazole (31.3%) while those from healthy pregnant women were mostly susceptible to itraconazole (59.6%) and miconazole (53.2%). The comparison of the susceptibility of fungi to antifungal agents revealed that the strains isolated form healthy women were significantly more susceptible to clotrimazole (p=0.003), itraconazole (p<0.001) and miconazole (p=0.001). No difference was found in susceptibility to pimaricin (p=0.54), nystatin (p=0.75), amphotericine B (p=0.84), ketoconazole (p=0.123) and fluconazole (p=0.61) between those two groups of fungal strains. Conclusions: Significant differences in susceptibility of fungi isolated from pregnant diabetic women to clotrimazole, itraconazole and miconazole suggest that diabetes has influence on resistance of fungal strains to some antifungal agents.