[Study of acute vulvovaginitis in sexually active adult women, with special reference to candidosis, in patients of the Francisco J. Muñiz Infectious Diseases Hospital].
The results of microbiological vaginal secretions samples obtained from 749 women (from July 2001 to July 2002) were studied in the Bacteriology Unit of the Francisco Javier Muñiz Hospital from Buenos Aires. All patients suffered acute vulvovaginitis were child bearing and sexually active women, 334 of them were HIV-positive. The following are the results of the microbiological studies: Lactobacillus spp 50.6%, Gardnerella vaginalis 25.6%, Candida spp 17.4%, Trichomonas vaginalis 5.3%, Neisseria gonorrhoeae 0.3% and B group Streptococcus 0.8%. Candida vaginitis was significantly more frequent in HIV-positive patients, (21.6% vs 14%; p = 0.0086); meanwhile, trichomoniasis was less common although the difference was not statistically significant (3.6 vs 6.7%, p = 0.0810). The following Candida species were isolated in this study: Candida albicans 76.8%, Candida glabrata 15.6%, Candida parapsilosis 2.9%, Candida tropicalis 1.5% and Candida krusei 0.7%. Eight cases (6.2%) of vaginitis were produced by two Candida species (C. albicans and C. glabrata), and in three cases (2.17%) Saccharomyces cerevisiae were isolated. Five women suffering acute vaginitis with Candida spp presented another etiologic agent of vaginal infection, three cases T. vaginalis and two cases G. vaginalis. The following are some of the most important findings of this study: 1) Half of the patients presented a normal microbial biota; 2) Candida spp vaginitis was significantly more frequent among HIV-positive women; 3) we observed a high incidence of Candida glabrata infections (15.9%), 4) 6.2% of vaginal candidiasis were caused by more than one Candida species and, 5) the susceptibility pattern of C. albicans and C. glabrata isolates against fluconazole was similar to the one observed in other studies. The majority of C. albicans isolates were susceptible to fluconazole (MIC90 = 0.5 microg/ml) meanwhile C. glabrata strains were much less susceptible to this drug (MIC50 and MIC90 = 32 microg/ml).
Buscemi
Luis
L
Unidad Bacteriología, Hospital de Infeccionsas Francisco Javier Muñiz, Buenos Aires, Argentina.
Arechavala
Alicia
A
Negroni
Ricardo
R
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001118:Argentina / Q000453:epidemiology; D002175:Candida / Q000187:drug effects / Q000302:isolation & purification; D002181:Candidiasis, Vulvovaginal / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D002353:Carrier State / Q000382:microbiology; D015897:Comorbidity; D025141:Drug Resistance, Fungal; D004967:Estrogens / Q000502:physiology; D005260:Female; D015725:Fluconazole / Q000494:pharmacology / Q000627:therapeutic use; D015658:HIV Infections / Q000453:epidemiology; D006782:Hospitals, Special / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010298:Parity; D015995:Prevalence; D012441:Saccharomyces cerevisiae / Q000302:isolation & purification; D012725:Sexual Behavior; D014247:Trichomonas Vaginitis / Q000453:epidemiology; D016585:Vaginosis, Bacterial / Q000453:epidemiology / Q000382:microbiology; D014848:Vulvovaginitis / Q000453:epidemiology* / Q000382:microbiology
D004967:Estrogens; D015725:Fluconazole