Author(s)

Humberto Fabio Boatto¹, Manoel João Batista Castello Girão¹, Elaine Cristina Francisco², Alexandre Paulo Machado^3*, Maria Sayonara de Moraes⁴, Olga Fischman²

¹Department of Gynecology, Faculty of Medicine, Federal University of Sao Paulo-UNIFESP, Sao Paulo, Brazil.
²Department of Microbiology, Immunology and Parasitology, Federal University of Sao Paulo-UNIFESP, Sao Paulo, Brazil.
³Department of Basic Sciences in Health, Faculty of Medicine, Federal University of Mato Grosso-UFMT, Sao Paulo, Brazil.
⁴Dermatologist of Sao Paulo State Secretary of Health, Sao Paulo, Brazil.

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.

Antifungal Susceptibility, Candida, Candidiasis Vulvovaginal, E-Test, Non-Albicans Species

Boatto, H. , Girão, M. , Francisco, E. , Machado, A. , de Moraes, M. and Fischman, O. (2016) Susceptibility to Fluconazole and Ketoconazole of Candida spp. Isolated from Primary and Episodic Vulvovaginites by E-Test (São Paulo, SP, Brazil). Open Journal of Obstetrics and Gynecology, 6, 689-697. doi: 10.4236/ojog.2016.612086.