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

摘要

Objective.Candida kruseicauses approximately 1% of vulvovaginal candidiasis (VVC) cases and is naturally resistant to fluconazole. Antifungal testing may be required ifC. kruseivaginitis fails to respond to non-fluconazole therapy, particularly in patients with recurrent infections.Design. We investigated the clinical characteristics and antifungal susceptibility profile of vaginalC. kruseiisolates. Between 2009 and 2012, we identified 560 unrelatedCandidaspp.-positive vaginal cultures, of which 28 (5.0%) wereC. krusei. These isolates were analyzed according to host factors and the clinical forms of VVC, and theirin vitrosusceptibility 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 ofC. kruseiin 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 Candidaspecies, can significantly aid in the selection of an effective antifungal agent. Thein vivoresponse ofC. kruseivaginitis to various antifungal therapeutics remains unknown and requires further research.