Prevalence of vulvovaginal candidiasis and antifungal susceptibility in gynecologic clinic women

Objective To survey the prevalence of vulvovaginal candidiasis in gynecologic clinic women and to determine the antifungal susceptibility of Candidas to amphotericin B, itroconazole, ketoconazole, flucytosine, and fluconazole. Methods Vaginal swabs were collected from unselected gynecologic clinic women. The antifungal susceptibility of 123 strains of Candidas to amphotericin B, itroconazole, ketoconazole, flucytosine, and fluconazole were detected respectively by E test. Results One thousand women were recruited, of whom 123 were diagnosed with vulvovaginal candidiasis. The prevalence of vulvovaginal candidiasis among gynecologic clinic women was 12 3% 22 3%(223/1 000) of the women had history of VVC and 1 3%(13/1 000) was recurrent VVC, which was 8 9%(11/123)of VVC. C. albicans was detected most frequently (91 3%),followed by C. glabrata (7 1%), C. tropicalis(1 6%) and C. krsei (0 8%).The MIC90 of amphotericin B, itroconazole, ketoconazole, flucytosine, and fluconazole to C.albicans was 0 38 μg/ml, 2 0 μg/ml, 0 25 μg/ml, 1 0 μg/ml and 16 μg/ml, respectively. By following the criteria of the interpretive breakpoints for antifungal susceptibility testing for the antifungal agents against Candidas, the resistant rates of C. albicans against amphotericin B, itroconazole, ketoconazole, flucytosine and fluconazole was 0 9%, 6 9%, 2 6%, 1 7%, and 2 6%. All eight strains of C. glabrata was susceptible or susceptible-dependent-upon-dose (SDD) to amphotericin B, ketoconazole,and flucytosine and was resistance to itroconazole. Two C. glabrata strains were resistant to fluconazole. Both of the C. tropicalis strains were susceptible or SDD to amphotericin B, ketoconazole, flucytosine, and fluconazole. One C. tropicalis strain was resistant to itroconazole. One C. krsei strains was susceptible or SDD to amphotericin B, ketoconazole, flucytosine, itroconazole, and fluconazole. Conclusions Vulvovaginal candidiasis is a common disease of gynecologic clinic women. C. albicans is the predominant Candida species in vulvovaginal candidiasis and shows some resistance to amphotericin B, itroconazole, ketoconazole, flucytosine and fluconazole. C. glabrata is susceptible or SDD to amphotericin B, ketoconazole and flucytosine, yet partially resistant to fluconazol, and is resistance to itroconazole.