Clinical Characteristics of Turkish Women withCandida kruseiVaginitis and Antifungal Susceptibility of theC. kruseiIsolates

Abstract

Objective. Candida krusei causes approximately 1% of vulvovaginal candidiasis (VVC) cases and is naturally resistant to fluconazole. Antifungal testing may be required if C. krusei vaginitis fails to respond to non-fluconazole therapy, particularly in patients with recurrent infections. Design. We investigated the clinical characteristics and antifungal susceptibility profile of vaginal C. krusei isolates. Between 2009 and 2012, we identified 560 unrelated Candida spp.-positive vaginal cultures, of which 28 (5.0%) were C. krusei. These isolates were analyzed according to host factors and the clinical forms of VVC, and their in vitro susceptibility to 10 antifungal agents was tested using a reference microdilution method. Results. We observed that perineal laceration and increased age (>50 years) were significant predictors of C. krusei in vaginal samples (P < 0.05). All isolates were susceptible to amphotericin B, caspofungin, ketoconazole, and miconazole. Additionally, susceptible dose-dependent and resistant rates were found for fluconazole as 42.9% and 57.1%, respectively. Remarkably, only 42.9% and 67.9% of the isolates were susceptible to itraconazole and voriconazole, respectively. Conclusions. Understanding local susceptibility patterns, especially those of non-C. albicans Candida species, can significantly aid in the selection of an effective antifungal agent. The in vivo response of C. krusei vaginitis to various antifungal therapeutics remains unknown and requires further research.

In vitro activity of econazole in comparison with three common antifungal agents against clinical Candida strains isolated from superficial infections

“…In the current study, all C. krusei isolates were resistant to the evaluated azoles, whereas in the study by Güzel et al, which evaluated vaginitis isolates [29], resistance rates of 57.1% and 32.1% against fluconazole and itraconazole were reported, respectively; also, all isolates were sensitive to miconazole. …”

Prevalence and Antifungal Susceptibility of Candida albicans Causing Vaginal discharge Among Pregnant Women in Lebanon

“…Recent emergence of NCAC, such as C.glabrata and C. krusei has been seen in the post FCZ era and in settings with azole selection pressure [31]. Worldwide, there is a variation in the distribution of Candida spp.…”

Clinical patterns and risk factors of vulvo-vaginal candidiasis among women of reproductive age attending a tertiary hospital in central India

“…Approximately 75% of women experience at least one episode of VVC during their life (3). However, an estimated 5% of women with vulvo-vaginal candidiasis experience recurrent vulvo-vaginitis (RVV), which is defined as four or more distinct episodes of vaginitis in a single year (4,5). Women having VVC present with spectrum of manifestations ranging from asymptomatic colonization to severe acute symptomatic infection (6).…”