Increased incidence of vulvovaginal candidiasis caused by Candida glabrata in Jordan

Due to the rising importance of Candida glabrata and other non-albicans Candida as principle human opportunistic pathogens, 356 women with abnormal vaginal discharge who attended a private obstetrics and gynecology clinic in Amman, Jordan, between January 1999 and February 2001 were examined. The isolation rate of Candida spp. from high-vaginal swabs was 44.9%. CHROMagar Candida and conventional mycological methods identified six isolated Candida spp., including C. albicans, C. glabrata, C. tropicalis, C. parapsilosis, C. krusei, and C. kefyr. The percentages of C. albicans, C. glabrata, and C. tropicalis isolates were 43.1%, 32.5%, and 8.1%, respectively. C. albicans was isolated in combination with C. tropicalis and C. krusei in two patients. Statistical analysis of the present results clearly show an increase in the incidence of vulvovaginal candidiasis caused by C. glabrata in the two study periods, 1994-1996 and 1999-2001 (P = 0.0186). In contrast, comparing the proportions of vulvovaginal candidiasis caused by C. albicans in the two periods, there was no significant difference. These results may have significant clinical implications, as C. glabrata are innately less susceptible to most antifungal agents than C. albicans; these findings support viewing this organism as a major pathogen.