Antifungal Susceptibilities Of Candida Species Causing Recurrent Vulvovaginal Candidiasis And Therapy Outcome

ObjectThe treatment of recurrent vulvovaginal candidiasis (RVVC)should combine intensive therapy and consolidation therapy. There is infrequent study on choosing nystatin for curing RVVC. This study assesses the efficacy of nystatin in curing RVVC, microecological features and the susceptibility of RVVC to diversified antifungal drugs.MethodsThe samples of vaginal secretion were obtained from 86 patients with RVVC and 91 healthy women. After being Gram-stained, those samples were examined by Nugent score system and vaginal microecology appraisal, with vaginal secretion subject to fungal culture, Candida strains identified, separated and subject to antifungal susceptibility test. The healing efficacy after intensive therapy and consolidation therapy for six months was evaluated.ResultsCandida albicans was found in samples of 86.4% patients in RVVC group and those of 89.5% patients in control group (P>0.05); and Candida glabrata was found in samples of 10.7% patients and those of 6.0% patients in respective groups. The susceptibility (including intermediate susceptibility) to nystatin, clotrimazole, itraconazole, fluconazole and miconazole were 100%, 73.3%, 88.3%, 93.4% and 88.4%. Samples with four points and more as assessed in Nugent score system accounted for 9.3% in RVVC group, 5.90% in RVVC-cured group and 12.1% in healthy control group(P>0.05). The fungology cure rate of Nystatin in terms of intensive therapy was 84.6% and that in terms of consolidation therapy was 67.3%.ConclusionThe main pathogenic bacteria in RVVC was Candida.albicans. The percentage of Candida glabrata grew. There were no significant differences among the susceptibilities of strains from RVVC and control groups to nystatin, clotrimazole, itraconazole, fluconazole and miconazole. Candida albicans was not resistent to nystatin. There were no significant differences among the RVVC group, the cure group and the control group regarding vaginal microecology. Nystatin achieved good effects in treatment of RVVC.