Species Distribution and Antifungal Susceptibility of Yeasts Isolated From Vaginal Mucosa

Abstract

Aims: Vulvovaginal candidiasis is one of the most common complaints in the medical clinic. In recent years, due to the increasing frequency of non-albicans species, the number of cases of therapeutic failure has increased considerably, generating the need for research to learn the profile of yeasts isolated in vulvovaginal candidiasis. The aims of this study were to collect samples of vaginal secretion, verify the presence of yeast, identify the species of yeast, and verify their in vitro susceptibility profile against six antifungal agents -amphotericin B, nystatin, fluconazole, itraconazole, ketoconazole and voriconazole. Materials and Methods: Vaginal secretion was collected from 130 patients with symptoms characteristic of vulvovaginal candidiasis (VVC). For amphotericin B, fluconazole, itraconazole, ketoconazole and voriconazole, the in-vitro tests were carried out using the commercial Etest susceptibility testing kit; for nystatin the disk diffusion method was used. Results: The yeasts isolated were: Candida albicans (90%), C. glabrata (5%), C. parapsilosis (3%) and C. tropicalis (2%). By the CLSI method, all the isolates were susceptible to fluconazole, ketoconazole, nystatin and voriconazole. Tests showed that 98.8% of the isolates were susceptible to amphotericin B and 97.6% to itraconazole. Conclusion: Although a high number of resistant strains were not found, these studies may help guide physicians to the most convenient therapeutic orientation, conducting treatment specific to the identified yeast species.

Urinary tract infections and Candida albicans

“…VVC is a common fungal infection among 75% of women around the world and is often easy to treat. This infection correlates with individual hygiene, sexual activities and social behaviors [ 2 , 40 ].…”

“…Therefore, it is important to control the prevalence of candidal UTIs in determined intervals. CB and VVC are linked to each other and can be recognized by detecting it in one sexual partner [ 1 , 40 ].…”

“…The treatment of VVC caused by FRNACA species is often achieved via gelatin capsules of vaginal boric acid, amphotericin B, and/or flucytosine cream. In the case of recurrent VVC, itraconazole together with an oral and topical probiotic including Lactobacillus acidophilus is recommended [ 6 , 9 , 18 , 40 ].…”

Susceptibility to Fluconazole and Ketoconazole of <i>Candida</i> spp. Isolated from Primary and Episodic Vulvovaginites by E-Test (São Paulo, SP, Brazil)

“…Changes of pH, vaginal microbiota, and the endogenous host factors may trigger the disease [1]- [4]. Candida albicans has been the most common causal agent and non-albicans species have been increasingly identified [4]- [7]. The overall increase of resistant microorganisms and the consequent occurrence of refractory cases for treatments commonly used have been quicken for the interest in researches to development of new antimicrobial drugs, therapeutic schemes and susceptibility tests [5] [8] [9].…”