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Susceptibility profile of vaginal yeast isolates from Brazil

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Abstract

Vaginal specimens for culture were obtained from two hundred and five immunocompetent, non-hospitalized patients selected among all women attending the Gynecology and Obstetric Ambulatory Clinic of the Universityof Espírito Santo, Brazil, during a 2-year period (From 1998 to 1999). Patients were checked for signs and symptoms of vulvovaginitis and previous use of topical and systemic antifungal drugs. Yeast isolates were identified by classical methods and the antifungal susceptibility profile was determined according to NCCLS microbroth assay.

The prevalence of vaginal yeast isolates from asymptomatic women was 25%(30/121) and 60% (50/84) among patients with symptoms of vulvovaginitis.Candida albicans was the most frequently isolated species in both groups (46% and 90%, respectively), followed by C. glabrata (13% and 6%, respectively). All isolates were susceptible to amphotericin B. Only ten isolates had dose dependent susceptibility (DDS) or resistance to azoles; and seven of these were non-albicans species.

Based on our results we suggest that species identification and antifungal susceptibility testing need not be routinely performed in immunocompetent women, and may be reasonable only for the minority of patients with complicated vulvovaginal candidiasis that fail to respond to therapy.

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References

  1. Sobel JD. Candidal vulvovaginitis. Clin Obstetr Gynecol 1993; 36(1):153-165.

    Google Scholar 

  2. Giraldo P, Von Nowaskoski A, Gomes FAM, Linhares I, Neves NA, Witkin SS. Vaginal colonization by Candida in asymptomatic women with and without a history of recurrent vulvovaginal candidiasis Obstetrics & Gynecology 2000, 95(3): 413-416.

    Google Scholar 

  3. Sobel ID, Vasquez JA. Symptomatic vulvovaginitis due to fluconazole-resistant Candida albicans in a female who was not infected with Human Immunodeficiency Virus. Clin Infect Dis 1996; 22: 726-727.

    PubMed  Google Scholar 

  4. Sobel JD. Current concepts: vaginitis. New Engl J Med 1997; 337(26):1896-1903.

    Article  PubMed  Google Scholar 

  5. Fidel PL, Sobel, JD. Immunopathogenesis of recurrent vulvovaginal candidiasis. Clin Microb Rev 1996; 9(3):335-348.

    Google Scholar 

  6. Fidel PL, Vasquez JA, Sobel JD. Candida glabrata, Review of epidemiology, pathogenesis and clinical disease with comparison to Candida albicans. Clin Microbiol Rev 1999; 12(1): 80-96.

    PubMed  Google Scholar 

  7. Sobel JD. Vulvovaginitis due to Candida glabrata. An emerging problem. Mycoses 1998; (Supp 12): 18-22.

  8. Baily GG, Perry FM, Denning DW, Mandal BK. Fluconazole-resistant candidosis in an HIV cohort. AIDS 1994; 8: 787-792.

    PubMed  Google Scholar 

  9. Maenza JR, Keruly JC, Moore RD, Chaisson RE, Merz WG, Gallant JE. Risk factors for fluconazole-resistant candidiasis in human immunodeficiency virus-infected patients. J Infect Dis 1996; 173: 219-225.

    PubMed  Google Scholar 

  10. Martins MD, Lozano-Chiu M, Rex JH. Point prevalence of oropharyngeal carriage of fluconazole-resistant Candida in human immunodeficiency virus-infected patients. Clin Infect Dis 1997, 25: 843-846.

    PubMed  Google Scholar 

  11. Kreger-Van Rij NJW. ed. The yeast, a taxonomic study. Amsterdam: Elsevier Science Publishers, 1984.

    Google Scholar 

  12. National Committee for Clinical Laboratory Standards (NCCLS) 1997. Reference method for broth dilution antifungal susceptibility testing of yeast. Approved standard M27-A, Wayne PA NCCLS; 17(9): 1-18.

    Google Scholar 

  13. Rex JH, Pfaller MA, Galgiani JN, Bortlett MS, Espinel-Ingroff A, Ghannoum MA, Lancaster M, Odds FC, Rinaldi MG, Walsh TJ, Barry AL. Development of interpretative breakpoints for antifungal susceptibility testing: Conceptual framework and analysis of in vitro-in vivo correlation data for fluconazole, itraconazole and Candida infections, Clin Infect Dis 1997; 24: 235-247.

    PubMed  Google Scholar 

  14. Rodríguez-Tudela JL, Martinez-Suárez JV Dronda F, Laguna F, Chaves F, Valencia E. Correlation of in vitro susceptibility test results with clinical response: A study of azole therapy in AIDS patients. J Antimicrob Chemother 1995; 35: 793-804.

    PubMed  Google Scholar 

  15. Duerr A, Sierra MF, Feldman J, Clarke LM, Ehrlich I, Dehovitz J. Immune compromised and prevalence of Candida vulvovaginitis in human immunodeficiency virus-infected women. Obst Gynecol 1997; 90(2): 252-256.

    Article  Google Scholar 

  16. Osborne NG, Grubin L, Pratson L Vaginitis in sexually active women: relationships to nine sexually transmitted organisms. Am J Obstet Gynecol 1982; 142: 962-967.

    PubMed  Google Scholar 

  17. Oriel JD, Patridge BM, Denny MJ, Coleman JC. Genital yeast infections. Br Med J 1972; 4: 761-764.

    PubMed  Google Scholar 

  18. Spinillo A, Capuzzo E, Gulminetti R, Marone P, Colonna L, Piazzi G. Prevalence of and risk factors for fungal vaginitis caused by non-albicans species. Am J Obst Gynecol 1997; 176(1):138-141.

    Google Scholar 

  19. Iwata K. Drug resistance in human pathogenic fungi. Eur. J. Epidemiol. 1992; 8(3): 407-421.

    Article  PubMed  Google Scholar 

  20. Johnson EM, Warnock DW. Azole drug resistance in yeast J Antimicrob Chemother 1995; 36: 751-755.

    PubMed  Google Scholar 

  21. Kitchen VS, Savage M, Harris JR. Candida albicans resistance in AIDS. J Infect Dis 1995; 22: 204-205.

    Google Scholar 

  22. Rex JH, Rinaldi MG, Pfaller MA. Resistance of Candida species to fluconazole. Antimicrob Agents Chemother 1995; 39(1): 1-8.

    PubMed  Google Scholar 

  23. Fidel PL Jr, Ginsburg KA, Cutright JL, Wolf NA, Leaman D, Dunlap K, Sobel JD. Vaginal-associated immunity in women with recurrent vulvovaginal candidiasis: Evidence for vaginal Th1-type responses following intravaginal challenge with Candida antigen. J Clin Infect Dis 1997; 176: 728-739.

    Google Scholar 

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Ribeiro, M., Dietze, R., Paula, C. et al. Susceptibility profile of vaginal yeast isolates from Brazil. Mycopathologia 151, 5–10 (2001). https://doi.org/10.1023/A:1010909504071

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