Title:Putative virulence factors of Candida species colonising asymptomatic pregnant Jordanian women

Author:Mohammad A Abu-Lubad, Ghada F Helaly, Amin A Aqel, Dua’a A Jarajreh, Ahlam M Al-kharabsheh, Seham M Abufraijeh, Eman M Albataineh and Nedal A Alnawaiseh

Abstract:Objectives: Pregnant women are frequently exposed to yeast colonisation and infection compared to non-pregnant women. This study was undertaken to investigate carriage rates of Candida species and their virulence factors in high vaginal samples from asymptomatic pregnant women as a probable predisposing factor for neonatal candidiasis.
Methods: High vaginal swabs were collected from 200 pregnant women from Al-Karak Governmental Hospital, Jordan from March to December 2018. Candida isolates were identified by their growth on CHROMagar Candida and Vitek2 automated system. Some virulence factors were determined.
Results: Among 200 swabs tested, 67 (33.5%) yielded Candida isolates as follows: C. ablicans, 28 (41.8%), while non-albicans Candida (NAC) were 39 (58.2%) isolates (p=0.04). C. parapsilosis was the most prevailed NAC species isolated, 29 (74.4%) followed by C. tropicalis: 6 (15.4%) while C. glabrata and C. krusei, each represented 2 (5.1%). Among C. albicans isolates, 27 (96.4%), 18 (64.3%), and 24 (85.7%) compared to 24 (82.7%), 4 (13.8%), and 25 (86.2%) among C. parapsilosis were positive for proteinase, phospholipase, and haemolysin respectively. The protease activity was the highest detected (88.1% of Candida isolates) compared to other enzymes but did not reach statistical significance between Candida species (p=0.215). Phospholipase activity was significantly detected among C. albicans isolates compared to other species (p <0.001). Insignificant differences in haemolysin production was observed among isolates (p= 0.134).
Conclusions: In Jordanian pregnant women, NAC, mainly C. parapsilosis, were the most frequently isolated Candida species from high vaginal swabs. Routine screening and treatment are recommended for pregnant women, irrespective of symptoms.
Keywords: Candida albicans; virulence factors; C. parapsilosis; asymptomatic pregnant women; non- Candida albicans.
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