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Epidemiology and Antifungal Susceptibilities of Yeasts Causing Vulvovaginitis in a Teaching Hospital

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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.

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Acknowledgments

This work was financially supported in part by grants CAI+D prog. RH and PEIS 2011 both from the Universidad Nacional del Litoral to G.G.E. and S.G., respectively. C. Dudiuk has a predoctoral fellowship from Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET).

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  1. Estefanía Mancilla

    Present address: Hospital San Carlos, Casilda, CP 2170, Santa Fe, Argentina

Authors and Affiliations

  1. 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

    Soledad Gamarra, Catiana Dudiuk, Estefanía Mancilla & Guillermo Garcia-Effron

  2. Catedra de Parasitología y Micología, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, CP 3000, Santa Fe, Argentina

    Soledad Gamarra, Catiana Dudiuk, Estefanía Mancilla & Guillermo Garcia-Effron

  3. Sección Microbiología, Laboratorio Central, Hospital Dr. José María Cullen, CP 3000, Santa Fe, Argentina

    Susana Morano, María Elena Nardin & Emilce de los Angeles Méndez

Authors
  1. Soledad Gamarra
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  2. Susana Morano
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  7. Guillermo Garcia-Effron
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Correspondence to Guillermo Garcia-Effron.

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Gamarra, S., Morano, S., Dudiuk, C. et al. Epidemiology and Antifungal Susceptibilities of Yeasts Causing Vulvovaginitis in a Teaching Hospital. Mycopathologia 178, 251–258 (2014). https://doi.org/10.1007/s11046-014-9780-2

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