title: Molecular identification and antifungal susceptibility of 186 Candida isolates from vulvovaginal candidiasis in southern China.
abstract: There is limited information regarding the molecular epidemiology and antifungal susceptibilities of Candida isolates using the Neo-Sensitabs method in patients with vulvovaginal candidiasis (VVC). From August 2012 to March 2013, 301 non-pregnant patients aged 18-50 years with suspected VVC were prospectively screened at a teaching hospital in southern China. The vaginal isolates were identified by DNA sequencing of internal transcribed spacer and the D1/D2 domain. Antifungal susceptibility testing of seven antifungal agents was performed using the Neo-Sensitabs tablet diffusion method. Candida species were isolated from 186 cases (61.79 %). The most common pathogen was Candida albicans (91.4 %), followed by Candida glabrata (4.3 %), Candida tropicalis (3.2 %) and Candida parapsilosis (1.1 %). The susceptibility rates to C. albicans were higher for caspofungin, voriconazole and fluconazole than those for itraconazole, miconazole, ketoconazole and terbinafine (P<0.01). The resistance rates to C. albicans were 4.7, 6.5, 7.1, 7.6, 12.3, 27.7 and 74.7 % for caspofungin, miconazole, itraconazole, voriconazole, fluconazole, ketoconazole and terbinafine, respectively. No drugs tested apart from fluconazole exhibited differences in resistance between C. albicans and non-albicans Candida isolates. The results demonstrate that, using DNA sequencing, C. albicans is the most common isolate from Chinese patients with VVC. Caspofungin, voriconazole and fluconazole may be preferable to other azoles and terbinafine in the treatment of VVC.
authors.affiliation: Department of Dermatology, Affiliated Hospital of Guangdong Medical College, Zhanjiang, Guangdong, PR China.
authors.forename: Xiao-Yu
authors.initials: XY
authors.lastname: Shi
authors.affiliation: Department of Dermatology, Affiliated Hospital of Guangdong Medical College, Zhanjiang, Guangdong, PR China.
authors.forename: Yan-Ping
authors.initials: YP
authors.lastname: Yang
authors.affiliation: Department of Gynecology and Obstetrics, Affiliated Hospital of Guangdong Medical College, Zhanjiang, Guangdong, PR China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Dermatology, Affiliated Hospital of Guangdong Medical College, Zhanjiang, Guangdong, PR China.
authors.forename: Wen
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Dermatology, Affiliated Hospital of Guangdong Medical College, Zhanjiang, Guangdong, PR China.
authors.forename: Jie-Di
authors.initials: JD
authors.lastname: Wang
authors.affiliation: Department of Dermatology, Affiliated Hospital of Guangdong Medical College, Zhanjiang, Guangdong, PR China.
authors.forename: Wen-Ming
authors.initials: WM
authors.lastname: Huang
authors.affiliation: Department of Dermatology, Affiliated Hospital of Guangdong Medical College, Zhanjiang, Guangdong, PR China.
authors.forename: Yi-Ming
authors.initials: YM
authors.lastname: Fan
mesh_terms: D000293:Adolescent; D000328:Adult; D000935:Antifungal Agents / Q000494:pharmacology*; D002175:Candida / Q000145:classification* / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D002181:Candidiasis, Vulvovaginal / Q000382:microbiology*; D002681:China; D004271:DNA, Fungal / Q000737:chemistry / Q000235:genetics; D004275:DNA, Ribosomal / Q000737:chemistry / Q000235:genetics; D021903:DNA, Ribosomal Spacer / Q000737:chemistry / Q000235:genetics; D025141:Drug Resistance, Fungal; D005260:Female; D006801:Humans; D008828:Microbiological Techniques / Q000379:methods*; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques / Q000379:methods*; D008969:Molecular Sequence Data; D012335:RNA, Ribosomal / Q000235:genetics; D017422:Sequence Analysis, DNA; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D004271:DNA, Fungal; D004275:DNA, Ribosomal; D021903:DNA, Ribosomal Spacer; D012335:RNA, Ribosomal; C065096:RNA, ribosomal, 26S