Analysis On Risk Factors And Drug Resistance Of Recurrent Vulvovaginal Candidiasis

ObjectiveTo investigate the pathogenic Candida species and drug resistance of recurrent vulvovaginal candidiasis(RVVC) and VVC in Changchun, find out the relative risk factors that affected them, so that we can provide basis for clinical prevention, diagnosis, rational drug use. MethodsFrom March 2013 to March 2015, a total of 230 Patients with recurrent Vulvovaginal candidiasis and 248 VVC femal controls were recruited into the survey in the The Second Hospital of Jilin university. The questionnaires were eonducted by investigator and data were analyzed by logisticstatistics, so we can find out whether they were responsible for RVVC. The yeasts isolated from Patients with VVC and RVVC were cultured and Purified routinely by Sabouraud and identified at the species level using CHROMagar Candida. Susceptibility and resistance of the isolates to fluconazole, itraconazole, and voriconazole were measured using the M27-A3 broth dilution method. Results1 、 RVVC group of 230 cases, with an average age of 33.16 years old with disabilities 5.89; VVC as a control group of 248 cases, mean age 32.92, 5.73 years old with disabilities. Statistical analysis showed that misuse of antibiotics, oral contraceptives, long-term use of immunosuppressive agents, uncontrolled diabetes, combined with other vaginal disease, history of induced abortion and behavioral habits(wearing tight synthetic underwear, long-term use pads) related as the risk factors of vulvovaginal candidiasis(P <0.05).2、A total of 478 isolates of Candida were collected. The most common specie was Candida albicans(361srains, 75.52%). Candida glabrata 46, accounting for 9.62%; Candida krusei 42, accounting for 8.79%; Candida tropicalis 20, accounting for 4.78%; 9 other species, accounting 1.88%. The ratio of non-albicans in RVVC group(43/248,17.34%) was significantly higher than that of VVC group(p<0.05).3、Sensitivity to candida drug from stong to weak is as follows: amphotericin B, voriconazole, itraconazole, fluconazole. The percentage of isolates with reduced susceptibility to fluconazole was significantly higher in the RVVC group than in the AVVC group(P < 0.05), the susceptibility of C.albicans were higher than nonC.albicans. Conclusion1 、 The risk factors responsible for RVVC are misuse of antibiotics, oral contraceptives, long-term use of immunosuppressive agents, uncontrolled diabetes, combined with other vaginal disease, history of induced abortion and some bad habits(wearing tight synthetic underwear, long-term use pads).2 、 Candida albicans was the main pathogenic species of VVC, followed by C.glabrate. Non-albicans spp of RVVC group was significantly higher than that of VVC.3、The highest rate of drug resistance is fluconazole, while the lowest is the amphotericin B. The sensitivity to fluconazole of RVVC group is significantly lower than that of VVC group, so as to the Candida albicans.