Vulvovaginal Candidiasis and Susceptibility ofPathogens to Antifungal Agents

Overview

Objective:
Analysis of the prevalence and species representation of pathogenic yeasts in patientswith vulvovaginal candidiasis. Determination of in vitro susceptibility of yeast isolates to clinicallyused antimycotic agents.Design: A retrospective clinical study of patients with positive vaginal cultures for the presence ofpathogenic yeast species.Setting: I. gynekologicko-pôrodnícka klinika LF UK a FN, Zochova 7, 811 03 Bratislava, Slovenskárepublika. Methods: Identification of yeast pathogens on the chromogenic medium CHROMagar CANDIDAand with API-CANDIDA identification system. In vitro susceptibility assays of clinical yeast isolatesto antifungal agents using the plate dilution method, NCCLS method and ATB-FUNGUS testsystem.Results: The highest prevalence of vulvovaginal candidiasis was found in women aged between20–30 years. Candida albicans was the most commonly identified species of pathogenic yeasts(87.4%). Of the non-albicans species, C. glabrata (6.3%) was the most prevalent species. C. glabrataand C. krusei clinical isolates were found to be generally less susceptible to several antifungals invitro as compared to C. albicans strains. A minimal number of resistant yeast isolates was observedfor econazole, clotrimazole and nystatin. A relatively high number of resistant strains wasobserved for some other azole antifungals (miconazole, ketoconazole, itraconazole, fluconazole).Conclusion: A successful treatment of vaginal mycotic infections requires the results of the microbiologicalanalyses. They will bring evidence to a physician of the presence and fate of the pathogen,of its sensitivity to antifungals, both of which are essential for the rational and successfultherapy of Candida vaginitis.

Key words:
vulvovaginal candidiasis, in vitro resistance, antifungal agents