Research On Strain And Drug Toleranceof Vulvovaginal Candidiasis

Objective: Vulvovaginal candidiasis (VVC) is common in obstetrics andgynecology infectious diseases, accounting for microbial vaginitis caused25.0%to30.0%, with recurrent vulvovaginal candidiasis (RVVC), clinical treatmentrather is tricky. The study to probe the strategies of treatment for recurrentvulvovagnial candidiasis (RVVC) and vulvovagnial candidiasis (VVC), typingof the strain and the drug sensitive test.Methods：2005December to2008December patients from gynecologicalout-patient of our hospital. Group RVVC: a total of97patients, mean age32.64±5.89years old; group VVC: a total of97patients, mean age28.92±6.41years old. Using sterile cotton swab and vaginal speculum takeing vaginalfornix secretions for fungal culture. The vaginal discharges of194patients werecultivated with35℃Sabouraud’s medium, among them there were97patientswith RVVC, and97patients with VVC. The samples were inoculated in API32℃candida krusei identification board and ATBTMFUNGUS3drug sensitiveboard.The results were analyzed by ATB Expression automatic microbiologicalassay apparatus. Statistical analysis using SPSS12.0software for statisticalanalysis. The difference between the groups compared using the chi-square test. Results: Among the cultivated vaginal discharge in194patients,156patientswere with candida albicans, accounting for80.41％(156／194);38patientswere with non-candida albicans, accounting for19.59％. In RVVC group therewere73patients with candida albicans accounting for75.26％(73／97), in VVCgroup there were83patients with candida albicans accounting for85.57％(83／97). In RVVC group the proportion of non-candida albicans was high thanthat in VVC group，and there were significant difference (P<0.05). InRVVC group the sensitive rate of candida krusei to fluconazole was lower thanthat in VVC group (P<0.05). Non-candida albicans to fluconazole susceptibilityrate (60.53%) lower than Candida albicans (81.41%). Sensitivity to candidadrug from weak to strong is as follows: fluconazole, flucytosine, voriconazole,itraconazole, amphotericin B.Conclusion: The main pathogenic bacteria of VVC and RVVC is candidaalbicans. In RVVC group the proportion of non-candida albicans is higherthan that in VVC group. The smooth candida was the most common innon-candida albicans. Itraconazole has the highest susceptibility in the azoles，isthe first choice of azole drugs in the treatment of VVC. In RVVC group thesensitive rate of candida krusei to fluconazole is significantly lower than that inVVC group, and the sensitive rate of non Candida albicans to fluconazole issignificantly lower than that of Candida albicans.