Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(6):300-304
DOI 10.1590/S0100-72032009000600006
PURPOSE: to study vulvovaginal candidiasis from the vaginal fluid of women with and without clinical suspicion, identifying the frequency of Candida spp., and associating it with intrinsic and extrinsic risk factors. METHODS: a total of 286 samples from patients attended in private practices and public health units from August 2005 to August 2007 were collected, being 121 women under clinical suspicion and 165, without. The samples were collected with sterile swabs, taken to the laboratory in 0.85% physiological solution, and then seeded in CHROMagar Candida and in 4% agar Sabourad with chloramphenicol. Classical identification procedures were carried out: macro and micromorphology, zymogram and auxanogram. Data obtained were analyzed by frequency tests and contingency tables (χ2). RESULTS: a total of 47.9% of the women under clinical suspicion got confirmation of candidiasis by the laboratorial tests. Among the patients without clinical suspicion (Control Group), 78.2% were vulvovaginal candidiasis negative according to the laboratorial tests. Candida albicans was the prevalent strain in 74.5% of the cases. There were significant differences among the positive cases, according to the patients from the two cities evaluated (p<0.05). Clothing was one differential aspect found among the two populations studied. CONCLUSIONS: the presence of predisposing factors does not necessarily define vulvovaginal candidiasis. Geographical localization has shown to be a relevant factor in the distribution of events. The type of clothing may be one of the reasons for it. Culture of samples from the vaginal contents, followed by microorganisms' identification, can be important.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(2):58-63
DOI 10.1590/S0100-72032005000200003
PURPOSE: to evaluate the distribution of yeast species isolated from the vagina in two cities of the South of Brazil and compare the in vitro susceptibility profile of these yeasts against some antifungals, which are used in clinical routine. METHODS: all women attended from January to June 2004 for vaginal routine examinations, independent of being symptomatic or not were included in the study. Only those who presented immunodeficiency like AIDS or any other genital infection were excluded. Samples of vaginal discharge from the women (Jaraguá do Sul - SC (n=130) and Maringá - PR (n=97)) were cultivated. The yeasts were identified and submitted to the susceptibility test against the antifungals fluconazole, nystatin and amphotericin B. RESULTS: the frequency of positive cultures for yeasts was the same in both cities; C. albicans was the most prevalent species (about 24%), but its frequency was different: in SC it corresponded to 77.4% of the yeasts both in symptomatic and asymptomatic women and in PR it was 50.0% with predominance in symptomatic women. We observed high rates of susceptibility to fluconazole and amphotericin B, but 51.1% of the yeasts presented dose-dependent susceptibility (DDS) to nystatin. C. albicans showed a higher tendency to be nystatin resistant (52.8% DDS) than non-albicans species (44.4%). CONCLUSIONS: our data showed geographic differences among the species of yeasts isolated from the vagina and suggest that this fact has clinical relevance considering the differences in susceptibility, especially regarding nystatin, which could be important for the management of vulvovaginal candidiasis.