Fluconazole and itraconazole susceptibility of vaginal isolates from Slovakia

1st Department of Obstetrics and Gynecology, Faculty of Medicine, Comenius University, Zochova 7, 811 03 Bratislava, Slovak Republic.
Mycopathologia (Impact Factor: 1.53). 03/2004; 157(2):163-9. DOI: 10.1023/B:MYCO.0000020594.35357.b0
Source: PubMed


Vulvovaginal candidiasis is a common mucosal infection caused by opportunistic yeasts of the Candida genus. In this study, we isolated and identified the yeast species in the vagina of patients treated in the gynecology clinic and tested in vitro activities of fluconazole and itraconazole against 227 clinical yeast isolates by the NCCLS microdilution method. C. albicans (87.6%) was the most frequently identified species followed by C. glabrata (6.2%) and C. krusei (2.2%). Almost thirteen percent of yeast strains were resistant to fluconazole and 18.5% were resistant to itraconazole. Cross-resistance analyses of C. albicans isolates revealed that fluconazole resistance and itraconazole resistance were also associated with decreased susceptibilities to other azole derivatives mainly to ketoconazole and miconazole. At the same time no cross-resistance to polyene antibiotics amphotericin B and nystatin was observed. These results support the notion that antifungal agents used to treat vaginitis may be contributing to the drug resistance problem by promoting cross-resistance to a range of clinically used antifungals.

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Available from: Julius Subík, Mar 05, 2014
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    • "Susceptibilities of clinical isolates to FLU and ITR were determined by the broth microdilution method recommended by the National Committee for Clinical Laboratory Standards , as described previously [12] [19]. Susceptibilities of isolates to 5FC, 4-NQO and TER were determined by agar broth dilution method using minimal YNB medium buffered to pH 7 (for 5FC and 4-NQO) [19] or pH 6 (for TER) [20]. "
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    • "Symptoms in oral candidosis are mostly general (Abraham, 2011; Gallè et al., 2011) but overgrowth of Candida in the vagina produces localised symptoms of itching, burning and irritation, while abnormal discharge, characterised by cottage cheese-like consistency may also occur. VVC can cause serious discomforts in females and also affects sexual activities (Sojakova et al., 2004) and the increased number of oral (Gallè et al., 2011) and vaginal yeast infections in the past few years has however, been a disturbing trend, with several theories being put forth to explain the apparent increase by opportunistic fungal infections. Some women first attempt to cure vulvovaginal yeast infections with do-ityourself treatments and natural remedies before turning to over-the-counter antifungal preparations (Dun, 1999); whereas, misuse of antifungal agents can also lead to colonisation with less susceptible species and to resistance among normally susceptible strains (Sobel et al., 2001). "
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    ABSTRACT: Eighteen antifungal drugs, five mentholated balms, sulphur and crude extracts of garlic (Allium sativum), African basil (Ocimum gratissimum) and ginger (Zingiber officinale) were tested for in vitro inhibitory potentials on 107 Candida strains obtained from human oral, high vaginal and endocervical swabs. Between 47.1 and 92.0% (C. albicans); 50.0 and 100% (C. glabrata); 27.2 and 90.9% (C. pseudotropicalis) and 57.1 and 100% (C. tropicalis) respectively were resistant to the antifungal drugs. Only Candiderm cream (clotrimazole) was generally least resisted (27.3-57.1%) by the Candida species, while all the Candida strains were resistant to the mentholated balms and sulphur. Garlic and ginger were respectively inhibitory against 33.3-54.4% and 50.0-72.7% of the Candida strains but low (14.2-16.1%) inhibition was recorded in African basil. In conclusion, significant in vitro resistance among vulvovaginal Candida species to some classes of antifungal drugs was recorded, indicating a serious clinical challenge in treatment of oral and vulvovaginal candidasis. Meanwhile, this study also reported significant in vitro inhibitory potentials of crude extracts of garlic and ginger on azole-/ griseofulvin-susceptible and resistant Candida species, and thereby, can serve as natural adjunct options for the treatment of oral and vulvovaginal candidasis, either as herbal toothpastes, topical anti-Candida agents, suppositories or as douches.
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    • "Sabatelli et al. [25] detected 6.4% resistance to fluconazole in 6,595 Candida isolates. Skrodeniene et al. [26] found 14 (15.1%) of 93 C. albicans strains resistant to fluconazole, while Sojakova et al. [27] reported fluconazole resistance as 13% in 227 Candida isolates. The rates of resistance are reported in a quite wide range in the studies carried out in our country as well. "
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    ABSTRACT: This study was performed to determine the distribution of Candida species isolated from the blood cultures of the patients hospitalized in our hospital and to investigate their antifungal susceptibility. Candida strains were identified at species level by using classical methods and API ID 32C (bioMerieux, France) identification kits. The susceptibility of the strains to amphotericin B, fluconazole, voriconazole, and caspofungin was evaluated by using the reference broth microdilution method in document M27-A3 of the Clinical and Laboratory Standards Institute. Of the 111 Candida strains isolated, 47.7% were identified as C. albicans and 52.3% as non-albicans Candida strains. The MIC ranges were 0.03-1 μ g/mL for amphotericin B, 0.125-≥64 μ g/mL for fluconazole, 0.03-16 μ g/mL for voriconazole, and 0.015-0.25 μ g/mL for caspofungin. All Candida strains were susceptible to amphotericin B and caspofungin. 10.8% isolates were resistant to fluconazole and 8.1% isolates were dose-dependent susceptible. While 0.9% isolate was resistant to voriconazole, 0.9% isolate was dose-dependent susceptible. In our study, C. albicans and C. parapsilosis were the most frequently encountered agents of candidemia and it was detected that voriconazole with a low resistance rate might also be used with confidence in the treatment of infections occurring with these agents, primarily besides amphotericin B and caspofungin.
    The Scientific World Journal 10/2013; 2013(3):236903. DOI:10.1155/2013/236903 · 1.73 Impact Factor
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