The detection rate offungi of the Candida genus in patients with urogenital candidiasis and an analysis of the indicators of their antimycotic resistance over a ten-year period (2010-2020)

Objective. To study the detection rate of various fungal species of the Candida genus and their susceptibility to antifungal drugs over the period from 2010 to 2020. Material and methods. Species identification was performed using 1927 Candida strains isolated from patients with urogenital candidiasis and their susceptibility to amphotericin B, clotrimazole, miconazole, ketoconazole, itraconazole, and fluconazole was determined. Results. There was a decrease in the specific share of C. albicans in the total structure of identified fungi of the Candida genus (from 90.2% in 2010 to 66.7% in 2020) and a pronounced tendency to increase the detection rate of non-albicans Candida strains: C. glabrata from 6.5% to 16.7%, C. krusei from 2.2% to 7.4%, C. parapsilosis from 0 to 4.6%, C. tropicalis from 1.1% to 2.8%, and C. kefyr from 0% to 1.8%. C. albicans and C. glabrata showed a high susceptibility to amphotericin B (99.2-100% and 88.2-100%, respectively), ketoconazole (98.6- 100% and 93.7-100%), and clotrimazole (92.7-100% and 87.5-100%); more than 80% of other Candida species were also susceptible to these drugs. Over the study period, C. albicans displayed a reduction in the level of susceptibility to fluconazole from 100% to 73.6% and to miconazole from 98.8% to 79.2%. In 2010-2020, there was a marked increase in itraconazole resistance in Candida species: C. albicans from 14.5% to 52.9%, C. krusei from 0 to 37.5%, and C. parapsilosis from 0 to 60.0%; more than 50% of the C. glabrata, C. tropicalis, and C. kefyr isolates were resistant to itraconazole. Conclusion. A dynamic a change in the species pattern of urogenital candidiasis pathogens, which is characterized by an increase in the proportion of non-albicans Candida species and by a decrease in the susceptibility of Candida fungi to a number of azole drugs (fluconazole, itraconazole, miconazole), necessitate the monitoring of antimycotic resistance and, if necessary, the optimization of the recommended therapy regimens for urogenital candidiasis according to the values obtained.

Candida albicans, Candida non-albicans, urogenital candidiasis, resistance, Candida albicans, non-albicans Candida, clotrimazole, fluconazole, itraconazole, miconazole