Distribution and antifungal susceptibility of Candida species in pelvic inflammatory disease patients from Hail, Saudi Arabia: A retrospective study.

BACKGROUND AND AIM: Pelvic inflammatory disease (PID) is a common gynecological condition caused primarily by bacterial pathogens. However, recent evidence suggests that fungal organisms, particularly Candida species, may also contribute, especially in immunocompromised individuals. This study aimed to investigate the ward-wise distribution of PID cases, determine the prevalence of Candida species, and assess their antifungal susceptibility patterns in Hail, Saudi Arabia.

METHODS

This retrospective cross-sectional study included 370 PID patients from multiple hospital departments between January 2019 and December 2023. Demographic, clinical, and microbiological data were analyzed. High vaginal swabs were cultured for Candida identification, and antifungal susceptibility testing was performed using the Vitek 2 system. Data were analyzed using SPSS (v.23).

RESULTS

The mean patient age was 34.52 ± 9.73 years, with the highest prevalence among women aged 25-44 years (54.9 %). Most patients were married (60.8 %). Most cases were reported in the gynecology emergency (45.4 %) and the outpatient (31.6 %) wards. Candida albicans was the predominant species (69.8 %), followed by C. glabrata (7.0 %) and other non-albicans species. No significant difference in species distribution was found between the emergency and non-emergency settings (p = 0.263). C. albicans demonstrated high susceptibility to caspofungin (97 %), fluconazole (95 %), and voriconazole (97 %).

CONCLUSION

Candida species, particularly C. albicans, are prevalent in PID cases in Hail. As a retrospective descriptive study, these findings are preliminary and do not establish causality. Nevertheless, routine fungal diagnostics and antifungal susceptibility testing are recommended, particularly for patients with risk factors or a history of poor response to antibiotic therapy.