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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.

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    • "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. "
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    • "Ribeiro et al. (2001) observed that all C. albicans isolates from VVC were susceptible to all antifungal drugs tested, except for C. glabrata and C. krusei isolates that showed dose dependent susceptibility (DDS) or resistance to azoles. However, another work has noted that 14.1% of C. albicans isolates were resistant to fluconazole and 16.6% to itraconazole, and only a single isolate of C. glabrata was resistant to fluconazole and seven to itraconazole (Sojakova et al., 2004). A study demonstrated the absence of resistant (Consolaro et al., 2005). "
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