Prevalência e susceptibilidade antifúngica de candida spp implicadas na candídiase vulvovaginal em gestantes

Abstract

Vulvovaginal Candidiasis (VVC) is an inflammatory disease of the vulva and vagina caused by yeasts from genus Candida. Approximately 75% of all pregnant women experience at least one VVC episode during their lives and 50% of them experience recurrent episodes. The diversity of epidemiological features related to VVC and the lack of local data support the importance of epidemiological studies that aim to identify these yeasts through classical (such as microculture) and modern (using Chromagar and automated identification) methodologies. The Candida species responsible for VVC in pregnant patients who attended Maternidade Escola Januário Cicco, Rio Grande do Norte-Brasil were confirmed through sequencing. Their susceptibility to selected antifungal agents (fluocytosine, fluconazole, voriconazole, amphotericin B, caspofungin and micafungin) was determined, and the association between patient related factors aided the construction of an epidemiological profile. From 41 samples 19 yeasts were identified phenotypically as Candida albicans, and one as Candida glabrata which is reported as the non-albicans species most frequently isolated from vulvovaginitis. Antifungal susceptibility testing performed by automated method (Vitek 2) showed that all strains were sensitive to the drugs tested, including the C. glabrata specimen despite its well-known resistance or dose-dependent susceptibility to azole derivatives. Regarding patient related factors, no statistically significant association between these and the establishment of VVC was found. It can be concluded that the laboratorial diagnosis of VVC is necessary prior to the administration of treatment, since only 48.78% of the patients had VVC but all of them were prescribed antifungal therapy after sample collection.