Susceptibility to Fluconazole and Ketoconazole of Candida spp. Isolated from Primary and Episodic Vulvovaginites by E-Test (São Paulo, SP, Brazil)

Purpose:To evaluate the profile of in vitro susceptibility of yeasts isolated from cases of primary and espisodicvulvovaginitis to two antifungal agents. Methods: 40 Candida isolates from episodes of vulvovaginal candidiasis wereidentified by classic methodologies. Thesusceptibility testing of the in vitro fluconazole and ketoconazole activity against the isolates was accessedby E-test. Results: C. albicans wasthe most common species identified in 70% of the occurrences followed by C. glabrata (20%), C. tropicalis (7.5%), and C.guilliermondii (2.5%). Inthe susceptibility profile to antifungal agents, 12.5% and 16.7% of theisolates obtained from primary and episodic vulvovaginal candidiasis wereresistant 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. Resistantstrains and non-albicans species wereverified more in cases of EVVC thanin PVVC. Clinical and mycologicalcure of patients with episodic vulvovaginal candidiasis or complicated casesoccurred after prolonged treatment and sometimes with multiple antifungals use.