Aims:We investigated the spectrum of yeasts isolated, and compared the epidemiological and laboratory characteristics of women carrying vulvovaginal Candida albicans with those carrying yeasts other than C albicans. Method: Between April and June 2001, 5802 consecutively received genital swabs from women were plated onto Candida ID chromogenic media (BioMerieux). Blue colonies were reported as C albicans; all other colonies (white and pink) were identified to species level using the Vitek YBC card (BioMerieux). In vitro susceptibility to amphotericin (AMB), fluconazole (FLU), itraconazole (ITZ), and voriconazole (VOR) was determined for approximately 40% of non-C albicans yeasts using a standardised microdilution method. Results: Yeast was isolated from 1221 women (21%). Of these, C albicans only was isolated from 1087 (89%) and yeasts other than C albicans from 129 (11%) women. C glabrata comprised 89 (69%) of the latter. Women in whom other yeasts were recovered were older than those with C albicans (mean 43, versus 33 years, p <0.001). All isolates tested (n=53) were susceptible to AMB and VOR. Seven (24%) C glabrata strains were susceptible to FLU with 21 (72%) testing susceptible-dose dependent. Conclusion: Yeasts other than C albicans are common vaginal isolates even in a primary care population. The species isolated are less susceptible to FLU than most C albicans. V ulvovaginal candidiasis is a common problem. The majority of infections are caused by Candida albicans, but there is increased awareness of the role of yeasts other than C albicans. It is important to identify these other yeasts because they tend to be less susceptible to the commonly used topical and oral azole antifungals 1 2 and are associated more frequently with recurrent infection than C albicans.3 Previous studies have been performed in tertiary care settings and included women with recurrent symptoms. Our study investigated the epidemiological and microbiological features of women carrying yeasts other than C albicans by examining genital specimens collected in the primary care setting, including those taken for antenatal or sexual health screening purposes. In addition, in vitro susceptibility testing was performed on 40% of yeasts other than C albicans.
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