Tehran University Medical Journal

Background: Vulvovaginal candidiasis (VVC) is a common infection, affecting up to 75% of women during their lifetimes. Approximately 5% of patients may experience recurrent VVC. Candida albicans is the most common causative agent of VVC. The objectives of this study were identification of candida species isolated of women with vulvovaginal candidiasis by molecular method in Arak city.
Methods: In this descriptive cross-sectional study, between Jun 2015 to March 2016 from 210 patients with vulvovaginal candidiasis referred to gynecology and obstetrics clinics in Arak city, Iran. Vaginal sampling was performed by wet sterile swabs. Samples were collected from vaginal discharge, vaginal posterior fornix, and sides of the vaginal wall. The swabs were investigated for direct exam and cultured on Sabouraud’s dextrose agar medium contain chloramphenicol. Yeast isolates DNA were identified by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Fungal genomic DNA was extracted from each isolate colony, glass bead method and after amplification of ITS1-ITS4 region with PCR assay, digested by MSP I restriction enzyme.
Results: From 210 patients with vulvovaginitis, 95 (45.2%) patients showed VVC. These patients were positive for Candida growth in culture and were infected with one Candida species. The age range of women with vulvovaginitis was between 14-60 years and the most VVC cases were in age group of 21-30 years. The most common Candida species isolated were Candida. albicans (70.5%), C. glabrata (20%), C. tropicalis (7.4%) and C. parapsilosis (2.1%).
Conclusion: Regarding to the results of this study, C. albicans was the most common Candida species, isolated from patients with vulvovaginal candidiasis and approximately 30% of this infection causing by non-albicans species of Candida.

Background: With increasing immunocompromised patients, fungal infections especially lung infection, have also increased. In this study, fungal contamination of the respiratory system in immunocompromised patients was evaluated.
Methods: This descriptive cross-sectional study was conducted in immunocompromised patients suspicious of pulmonary infections referring to specialized lung clinic of Amir-Al-Momenin University Hospital in Arak City, Iran, from April 2017 to June 2018. Of these 64 patients, including 35 women and 29 men, were selected. After recording the demographic information, a bronchoalveolar lavage (BAL) sample was prepared by the physician from these patients and was immediately sent to the medical mycology laboratory, school of medicine. Bronchoalveolar lavage specimens were investigated by Grocott-Gomori's methenamine silver (GMS) staining and culture method. Data were analyzed by SPSS software, version 16 (IBM SPSS, Armonk, NY, USA).
Results: Of 64 patients, 9 (14%) were infected with pulmonary fungal infections. Among the patients infected with fungal infection, 9 (100%) were positive in the culture examine and 8 (72%) by GMS staining. Among infected people, 7 (77.8%) were female and 2 (22.2%) were male. The most common isolated fungi were Candida albicans, Aspergillus fumigatus and Mucor species (2 cases). The highest infection was seen in the age group of less than 60 (33.3%). 66.7% of infections were among the unemployed persons and 33.3% of other cases of infection were seen in people with free jobs, workers and employees. The most important factors in the development of pulmonary fungal infections in the patients were: 5 cases of malignancy (33.3%), corticosteroid use in 2 cases (33.3%), tuberculosis in 1 case (22.2%) and diabetes mellitus in 1 case (11.2%). There was no significant relationship between fungal contamination with sex, age, occupation, marriage and type of disease.
Conclusion: The results of this study showed that immunocompromised patients are prone to fungal infections, especially Candidiasis and Aspergillosis. Therefore, the use of control methods to reduce the probability of such patients to fungal infections should be considered.