Article

Fluconazole and itraconazole susceptibility of vaginal yeast isolates from Slovakia

1st Department of Obstetrics and Gynecology, Faculty of Medicine, Comenius University, Zochova 7, 811 03 Bratislava, Slovak Republic.
Mycopathologia (Impact Factor: 1.55). 03/2004; 157(2):163-9. DOI: 10.1023/B:MYCO.0000020594.35357.b0
Source: PubMed

ABSTRACT 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.

Download full-text

Full-text

Available from: Julius Subík, Mar 05, 2014
0 Followers
 · 
112 Views
 · 
62 Downloads
  • Source
    • "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]. "
  • Source
    • "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. "
    [Show abstract] [Hide abstract]
    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; 2013:236903. DOI:10.1155/2013/236903 · 1.73 Impact Factor
  • Source
    • "Candida glabrata is an opportunistic human pathogen responsible for candidaemia. Behind C. albicans, this haploid yeast is considered to be the second most commonly isolated Candida species from both bloodstream (Pfaller et al., 1999) and vaginal infections (Sojakova et al., 2004). It is evolutionarily more closely related to Saccharomyces cerevisiae than C. albicans. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The PDR16 gene encodes the homologue of Sec14p participating in protein secretion, regulation of lipid synthesis and turnover in vivo, and acting as a phosphatidylinositol transfer protein in vitro. This gene is also involved in regulation of multidrug resistance in Saccharomyces cerevisiae and pathogenic yeasts. Here, we report the results of functional analysis of the CgPDR16 gene whose mutation has been previously shown to enhance the fluconazole sensitivity in Candida glabrata mutant cells. We have cloned the CgPDR16 gene which was able to complement the pdr16Δ mutation in both C. glabrata and S. cerevisiae. Along with fluconazole, the pdr16Δ mutation resulted in the increased susceptibility of mutant cells to several azole antifungals without changes in the sensitivity to polyene antibiotics, cycloheximide, NQO, 5-fluorocytosine and the oxidants inducing intracellular formation of reactive oxygen species. The susceptibility of the pdr16Δ mutant strain to itraconazole and 5-fluorocytosine was enhanced by CTBT (7-chlorotetrazolo[5,1-c]benzo[1,2,4]triazine) inducing oxidative stress. The pdr16Δ mutation increased the accumulation of rhodamine 6G in mutant cells, decreased the level of itraconazole resistance caused by gain-of-function mutations in the CgPDR1 gene, and reduced the cell surface hydrophobicity and biofilm production. These results point to the pleiotropic phenotype of the pdr16Δ mutant and support the role of the CgPDR16 gene in the control of drug susceptibility and virulence in the pathogenic C. glabrata. This article is protected by copyright. All rights reserved.
    Yeast 08/2013; 30(10). DOI:10.1002/yea.2978 · 1.74 Impact Factor
Show more