Yeast vaginitis during pregnancy: susceptibility testing of 13 antifungal drugs and boric acid and the detection of four virulence factors

Kalkancı, Ayşe; Güzel, Ahmet Barış; Khalil, Israa Ibrahim Jabban; Aydın, Merve; İlkit, Macit; Kuştımur, Semra

doi:10.3109/13693786.2012.662597

Cited by 38 publications

(34 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…but not with other studies (1,18). These inconsistent findings may be due to the different geographical regions, differences in choice of initial agents leading to different stress responses, and the tolerance of Candida species towards antifungal agents.…”

Section: Discussioncontrasting

confidence: 46%

Genotypes and Susceptibility of Candida Species Causing Acute and Recurrent Vulvovaginitis

Manaen

Ling

2017

Jundishapur J Microbiol

View full text Add to dashboard Cite

Background: Candida albicans genotypes derived from PCR-based techniques targeting 25S rDNA have been shown to correlate with antifungal susceptibility and virulence factors. However, this method has not been used in isolates recovered from recurrent vulvovaginal candidiasis. Comparing intron-based genotypes with the drug susceptibility of isolates recovered from recurrent vulvovaginitis may aid in epidemiological studies and better patient management. Objectives: The purpose of this study was to investigate the genetic diversity of isolates involved in vulvovaginal candidiasis and their susceptibility to seven antifungal agents. Methods: Candida genotyping based on the presence or absence of a group I intron by PCR targeting 25S rDNA and drug susceptibility assays using a modified Alamar Blue broth microdilution method were carried out. Fisher's exact test and the Mann-Whitney U test were performed, and P < 0.05 was considered statistically significant. Results: Candida albicans was the predominant species among 384 Candida isolates followed by C. glabrata in acute and C. tropicalis in recurrent vulvovaginitis. Candida albicans from acute infections were more susceptible to fluconazole than isolates from recurrent cases but more resistant to miconazole and amphotericin B. The dominant genotype A was resistant to itraconazole and demonstrated higher minimal inhibitory concentrations (MICs) to 5-fluorocytosine and itraconazole. All C. albicans and nonalbicans species. with the group I intron were susceptible to 5-fluorocytosine. Conclusions: Candida albicans is the predominant cause of acute and recurrent vulvovaginal candidiasis, and drug susceptibility differed significantly among type of infection. Strain differences based on the group I intron may not be clinically significant in disease recurrence. However, the presence or absence of the group I intron has significant impact on antifungal MICs and resistance. Moreover, the group I intron in C. albicans and non-albicans may be the most important factor related to 5-fluorocytosine susceptibility.

show abstract

Section: Discussioncontrasting

confidence: 46%

Genotypes and Susceptibility of Candida Species Causing Acute and Recurrent Vulvovaginitis

Manaen

Ling

2017

Jundishapur J Microbiol

View full text Add to dashboard Cite

show abstract

“…Currently, there are no published criteria for defining econazole and sulconazole susceptibility [13]. These results were expressed in terms of the MIC range and the MIC 50 , and MIC 90 values for each antifungal agent.…”

Section: Methodsmentioning

confidence: 99%

Clinical Characteristics of Turkish Women withCandida kruseiVaginitis and Antifungal Susceptibility of theC. kruseiIsolates

Güzel

Aydın

Meral

et al. 2013

Infectious Diseases in Obstetrics and Gynecology

Self Cite

View full text Add to dashboard Cite

Objective. Candida krusei causes approximately 1% of vulvovaginal candidiasis (VVC) cases and is naturally resistant to fluconazole. Antifungal testing may be required if C. krusei vaginitis fails to respond to non-fluconazole therapy, particularly in patients with recurrent infections. Design. We investigated the clinical characteristics and antifungal susceptibility profile of vaginal C. krusei isolates. Between 2009 and 2012, we identified 560 unrelated Candida spp.-positive vaginal cultures, of which 28 (5.0%) were C. krusei. These isolates were analyzed according to host factors and the clinical forms of VVC, and their in vitro susceptibility to 10 antifungal agents was tested using a reference microdilution method. Results. We observed that perineal laceration and increased age (>50 years) were significant predictors of C. krusei in vaginal samples (P < 0.05). All isolates were susceptible to amphotericin B, caspofungin, ketoconazole, and miconazole. Additionally, susceptible dose-dependent and resistant rates were found for fluconazole as 42.9% and 57.1%, respectively. Remarkably, only 42.9% and 67.9% of the isolates were susceptible to itraconazole and voriconazole, respectively. Conclusions. Understanding local susceptibility patterns, especially those of non-C. albicans Candida species, can significantly aid in the selection of an effective antifungal agent. The in vivo response of C. krusei vaginitis to various antifungal therapeutics remains unknown and requires further research.

show abstract

“…It differs from other Candida species because it is monomorphic, non-pseudohypha forming, and it has a haploid genome 9 . C glabrata is the second most frequently occurring fungus10 and the main non-albicans species that causes Candida vulvovaginitis. Pregnancy represents a risk factor for the occurrence of vulvovaginal candidiasis.…”

Section: Discussionmentioning

confidence: 99%

Severe systemic candidiasis following immunomodulation therapy in in vitro fertilisation-embryo transfer (IVF-ET)

et al. 2014

View full text Add to dashboard Cite

A 41-year-old nulliparous woman, with a medical history of unexplained infertility and multiple in vitro fertilisation (IVF) cycles with immunosuppressive therapy, was admitted to our tertiary obstetrics unit with sepsis at 18 weeks of pregnancy with dichorionic diamniotic twins.Candida glabratawas grown from her blood cultures, then subsequently from the liquor and placentae. She was treated with intravenous ambisome (amphotericin), but unfortunately, the infection resulted in the rupture of her membranes, preterm labour and the demise of her twins. She delivered both twins at 23 weeks, 3 days apart. The antifungal agent was changed to high-dose fluconazole after delivery for 2 weeks and she is now well. Women undergoing IVF-embryo transfer with immunomodulation therapy have a potential risk of developing candidal chorioamnionitis and sepsis.

show abstract

Yeast vaginitis during pregnancy: susceptibility testing of 13 antifungal drugs and boric acid and the detection of four virulence factors

Cited by 38 publications

References 38 publications

Genotypes and Susceptibility of Candida Species Causing Acute and Recurrent Vulvovaginitis

Genotypes and Susceptibility of Candida Species Causing Acute and Recurrent Vulvovaginitis

Clinical Characteristics of Turkish Women withCandida kruseiVaginitis and Antifungal Susceptibility of theC. kruseiIsolates

Severe systemic candidiasis following immunomodulation therapy in in vitro fertilisation-embryo transfer (IVF-ET)

Contact Info

Product

Resources

About