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  Česky / Czech version Čes. Gynek. 68, 2003, č. 1s. 24-29
 
Vulvovaginal Candidiasis and Susceptibility of Pathogens to Antifungal Agents  
Sojáková M.1, Liptajová D.2, Šimončičová M.3, Borovský M.1, Šubík J.2 

1I. gynekologicko-pôrodnícka klinika LFUK a FN, Zochova 7, 811 03 Bratislava, prednosta prof. MUDr. M. Borovský, CSc. 2Katedra mikrobiológie a virológie, Prírodovedecká fakulta, Univerzita Komenského, 842 15 Bratislava, vedúci katedry prof. RNDr. Ing. M. Kettner, DrSc. 3Mikrobiologický ústav, Lekárska fakulta UK, 811 08 Bratislava, prednosta prof. MUDr. D. Kotulová, CSc.
 


Summary:

       Objective: Analysis of the prevalence and species representation of pathogenic yeasts in patients with vulvovaginal candidiasis. Determination of in vitro susceptibility of yeast isolates to clinically used antimycotic agents. Design: A retrospective clinical study of patients with positive vaginal cultures for the presence of pathogenic yeast species. Setting: I. gynekologicko-pôrodnícka klinika LF UK a FN, Zochova 7, 811 03 Bratislava, Slovenská republika. Methods: Identification of yeast pathogens on the chromogenic medium CHROMagar CANDIDA and with API-CANDIDA identification system. In vitro susceptibility assays of clinical yeast isolates to antifungal agents using the plate dilution method, NCCLS method and ATB-FUNGUS test system. Results: The highest prevalence of vulvovaginal candidiasis was found in women aged between 20–30 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. glabrata and C. krusei clinical isolates were found to be generally less susceptible to several antifungals in vitro as compared to C. albicans strains. A minimal number of resistant yeast isolates was observed for econazole, clotrimazole and nystatin. A relatively high number of resistant strains was observed for some other azole antifungals (miconazole, ketoconazole, itraconazole, fluconazole). Conclusion: A successful treatment of vaginal mycotic infections requires the results of the microbiological analyses. 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 successful therapy of Candida vaginitis.

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

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