TITLE:
Susceptibility to Fluconazole and Ketoconazole of Candida spp. Isolated from Primary and Episodic Vulvovaginites by E-Test (São Paulo, SP, Brazil)
AUTHORS:
Humberto Fabio Boatto, Manoel João Batista Castello Girão, Elaine Cristina Francisco, Alexandre Paulo Machado, Maria Sayonara de Moraes, Olga Fischman
KEYWORDS:
Antifungal Susceptibility, Candida, Candidiasis Vulvovaginal, E-Test, Non-Albicans Species
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.6 No.12,
November
7,
2016
ABSTRACT: Purpose:
To evaluate the profile of in vitro susceptibility of yeasts isolated from cases of primary and espisodic
vulvovaginitis to two antifungal agents. Methods: 40 Candida isolates from episodes of vulvovaginal candidiasis were
identified by classic methodologies. The
susceptibility testing of the in vitro fluconazole and ketoconazole activity against the isolates was accessed
by E-test. Results: C. albicans was
the most common species identified in 70% of the occurrences followed by C. glabrata (20%), C. tropicalis (7.5%), and C.
guilliermondii (2.5%). In
the susceptibility profile to antifungal agents, 12.5% and 16.7% of the
isolates obtained from primary and episodic vulvovaginal candidiasis were
resistant to fluconazole, respectively. To ketoconazole, we found that 6.25%
and 12.5% of the isolates respectively from primary vulvovaginal candidiasis
(PVVC) and episodic vulvovaginal candidiasis (EVVC) had high MIC values. Conclusions:
E-test is a reliable method for the susceptibility testing of Candida spp. due to its simplicity, reproducibility, and lack of specialized equipment. Resistant
strains and non-albicans species were
verified more in cases of EVVC than
in PVVC. Clinical and mycological
cure of patients with episodic vulvovaginal candidiasis or complicated cases
occurred after prolonged treatment and sometimes with multiple antifungals use.