Microbiological Findings in Patients with RecurrentVulvovaginal Candidiasis in Faculty Hospital HradecKrálové in the Years 1995-2002

Overview

Objective:
To evaluate the microbiological fi ndings in the patients with the recurrent vulvovaginalcandidiasis (RVVC) with a focus on the establishment of fungal etiology and its in vitro antifungalsusceptibility.Design: Retrospective clinical and laboratory study.Setting: Department of Obstetrics and Gynecology, Medical Faculty Hradec Králové, Charles University,Prague, Department of Clinical Microbiology, Medical Faculty Hradec Králové, CharlesUniversity, Prague, Department of Biological and Medical Sciences, Faculty of Pharmacy HradecKrálové, Charles University, Prague.Methods: An analysis of clinical and anamnestic data in outpatients of the Dept. of Obstetrics andGynecology and the laboratory data from the microbiological examinations performed in theDept. of Clinical Microbiology from 1995 to 2002.Results: Candida albicans accounted for 88.5% of the episodes of RVVC in the setting of 56 patients.Non-albicans Candida species were represented especially by C. glabrata (4.9%) and C.krusei (3.1%). There were no considerable differences between the spectrum of RVVC and acutevulvovaginal candidiasis with the exception of Saccharomyces cerevisiae (0.7% in RVVC vs. 3.7%in acute VVC). Mycological fi ndings in 61 (20.5%) samples were accompanied by bacterial microbiotawith the predominance of Streptococcus agalactiae (n=15) and Gardnerella vaginalis (n=9).Decreased antifungal susceptibility determined by the disk test was observed in the strains of C.glabrata, C. krusei and S. cerevisiae, the other yeast isolates being susceptible to all ten antifungaldrugs tested.Conclusion: The microbiological examination was decisive for the establishment of the diagnosisof RVVC in most cases. The most frequent etiological agents responsible for the attacks of RVVCas well as for acute vulvovaginal candidiasis was C. albicans, which was generally susceptible toantifungal drugs.

Key words:
vulvovaginal candidiasis, Candida, Saccharomyces, antifungal drugs, microbiota,vagina