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. |
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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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