Fluconazole resistant non-albicans vaginal yeast in HIV seronegative women with vaginal discharge in Pune, India
Kairon, R.; Godbole, S.; Kulkarni, S.; Ghate, M.; Sane, S.; Mehendale, S.; Risbud, A.; Shrotri, A.; Bharucha, K.
International Journal of Infectious Diseases Ijid Official Publication of the International Society for Infectious Diseases 8(4): 251-252
2004
ISSN/ISBN: 1201-9712 PMID: 15234330 DOI: 10.1016/j.ijid.2003.11.007Document Number: 256221
A study was conducted to assess the fluconazole susceptibility and potential host factors associated with vaginal Candida species from women with vaginal discharge. Vaginal swabs were obtained from 133 of 186 women who presented with discharge due to reproductive tract infections at an STI clinic in a tertiary care government hospital, in Pune, Maharashtra, India, between April 2001 and August 2002. Candida isolates obtained were speciated and evaluated for in vitro fluconazole susceptibility by broth microdilution. Species distribution and fluconazole susceptibility of 45 Candida strains recovered from vaginal swabs showed 27 (60%) C. albicans and 18 (40%) non-albicans strains, of which 12 (66.7%) were speciated as C. glabrata [Torulopsis glabrata]. The minimum inhibitory concentration (MIC)90 of fluconazole against C. albicans and C. glabrata were 4 micro g/ml and 32 micro g/ml, respectively. Although intrinsically resistant to fluconazole, observed MICs against C. krusei isolates were within recommended MIC limits of C. krusei ATCC 6258 quality control strain used for the assay. Resistant/susceptible dose-dependent status was significantly associated with non-albicans Candida (P=0.001). Among host factors analysed for the species recovered, non-albicans Candida were marginally associated with HIV seronegative status (P=0.06). Women with itching were more likely to have C. albicans (P=0.006) and 7/19 (36.8%) women with vaginal candidiasis had non-albicans Candida (P=0.712). These preliminary findings emphasize the need for monitoring susceptibility and to study determinants of azole-resistant strains, including markers for previous azole exposure, to prevent and control their spread in this population.
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