Accéder au contenu
MilliporeSigma

Epidemiology and antifungal susceptibilities of yeasts causing vulvovaginitis in a teaching hospital.

Mycopathologia (2014-07-10)
Soledad Gamarra, Susana Morano, Catiana Dudiuk, Estefanía Mancilla, María Elena Nardin, Emilce de Los Angeles Méndez, Guillermo Garcia-Effron
RÉSUMÉ

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.

MATÉRIAUX
Référence du produit
Marque
Description du produit

Sigma-Aldrich
Fluconazole, ≥98% (HPLC), powder
Sigma-Aldrich
Itraconazole, ≥98% (HPLC)
Sigma-Aldrich
Clotrimazole
USP
Fluconazole, United States Pharmacopeia (USP) Reference Standard
Supelco
Clotrimazole, Pharmaceutical Secondary Standard; Certified Reference Material
Supelco
Fluconazole, Pharmaceutical Secondary Standard; Certified Reference Material
USP
Clotrimazole, United States Pharmacopeia (USP) Reference Standard
Fluconazole, European Pharmacopoeia (EP) Reference Standard
Clotrimazole, European Pharmacopoeia (EP) Reference Standard
Itraconazole, European Pharmacopoeia (EP) Reference Standard
Clotrimazole for peak identification, European Pharmacopoeia (EP) Reference Standard
Fluconazole for peak identification, European Pharmacopoeia (EP) Reference Standard
Supelco
Clotrimazole, VETRANAL®, analytical standard