title: Epidemiology and antifungal susceptibilities of yeasts causing vulvovaginitis in a teaching hospital.
abstract: Vulvovaginal candidiasis is one of the most common mycosis. However, the information about antifungal susceptibilities of the yeasts causing this infection is scant. We studied 121 yeasts isolated from 118 patients with vulvovaginal candidiasis. The isolates were identified by phenotypic and molecular methods, including four phenotypic methods described to differentiate Candida albicans from C. dubliniensis. Antifungal susceptibility testing was performed according to CLSI documents M27A3 and M27S4 using the drugs available as treatment option in the hospital. Diabetes, any antibacterial and amoxicillin treatment were statistically linked with vulvovaginal candidiasis, while oral contraceptives were not considered a risk factor. Previous azole-based over-the-counter antifungal treatment was statistically associated with non-C.albicans yeasts infections. The most common isolated yeast species was C. albicans (85.2 %) followed by C. glabrata (5 %), Saccharomyces cerevisiae (3.3 %), and C. dubliniensis (2.5 %). Fluconazole- and itraconazole-reduced susceptibility was observed in ten and in only one C. albicans strains, respectively. All the C. glabrata isolates showed low fluconazole MICs. Clotrimazole showed excellent potency against all but seven isolates (three C. glabrata, two S. cerevisiae, one C. albicans and one Picchia anomala). Any of the strains showed nystatin reduced susceptibility. On the other hand, terbinafine was the less potent drug. Antifungal resistance is still a rare phenomenon supporting the use of azole antifungals as empirical treatment of vulvovaginal candidiasis.
authors.affiliation: Laboratorio de Micología y Diagnóstico Molecular, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, CONICET, Ciudad Universitaria UNL (Ruta 168), C.C. 242-S3000ZAA, CP 3000, Santa Fe, Santa Fe, Argentina.
authors.forename: Soledad
authors.initials: S
authors.lastname: Gamarra
authors.forename: Susana
authors.initials: S
authors.lastname: Morano
authors.forename: Catiana
authors.initials: C
authors.lastname: Dudiuk
authors.forename: Estefanía
authors.initials: E
authors.lastname: Mancilla
authors.forename: María Elena
authors.initials: ME
authors.lastname: Nardin
authors.forename: Emilce
authors.initials: E
authors.lastname: de Los Angeles Méndez
authors.forename: Guillermo
authors.initials: G
authors.lastname: Garcia-Effron
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D000935:Antifungal Agents / Q000494:pharmacology*; D002175:Candida / Q000145:classification* / Q000187:drug effects* / Q000302:isolation & purification; D002181:Candidiasis, Vulvovaginal / Q000453:epidemiology* / Q000382:microbiology*; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011247:Pregnancy; D012307:Risk Factors; D012441:Saccharomyces cerevisiae / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification; D055815:Young Adult
chemical_list: D000935:Antifungal Agents