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Prevalence of and risk factors for fungal vaginitis caused by non-albicans species

      Abstract

      OBJECTIVE: Our purpose was to evaluate the prevalence of symptomatic yeast vaginitis caused by non-albicans species among patients attending a vaginitis clinic over an 8-year period. STUDY DESIGN: A retrospective study of 1263 patients with symptomatic yeast vaginitis confirmed by culture techniques was performed. RESULTS: The prevalence of symptomatic fungal vaginitis caused by non-albicans species increased from 9.9% (10/101) in 1988 to 17.2% (36/209) in 1995 (χ2 for trend = 9.33, p = 0.002). Non-albicans species were found more frequently in known human immunodeficiency virus–seropositive patients (23/102 vs 143/1161, odds ratio 2.07, 95% confidence interval 1.2 to 3.46) than in seronegative subjects or subjects of unknown status for the virus. Recurrent vaginal candidiasis was an additional risk factor for vaginitis caused by non-albicans species (odds ratio 2.47, 95% confidence interval 1.72 to 3.52). The increase in non-albicans isolates during the study period was confirmed in stratified analysis and in the subgroup of self-referred patients with no history of either human immunodeficiency virus infection or recurrent vaginal candidiasis. CONCLUSION: The prevalence of fungal vaginitis caused by non-albicans species has increased sharply in the setting of a vaginitis clinic. The characteristics of risk factors suggest that fungal cultures should be done routinely in human immunodeficiency virus–seropositive subjects with suspected vaginal candidiasis and in patients with recurrent vaginal infection. (Am J Obstet Gynecol 1997;176:138-41.)

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      References

        • Sobel JD.
        Vaginal infections in adult women.
        Med Clin North Am. 1990; 74: 1573-1601
        • Horowitz BJ.
        Mycotic vulvovaginitis: a broad overview.
        Am J Obstet Gynecol. 1991; 165: 1188-1192
        • Bingham JS.
        Vulvovaginal candidiasis: an overview.
        Acta Derm Venereol. 1986; 121: 39-46
        • Sobel JD.
        Candidal vulvovaginitis.
        Clin Obstet Gynecol. 1993; 36: 153-165
        • Law D
        • Moore CB
        • Wardle HM
        • Ganguli LA
        • Keaney MGL
        • Denning DW
        High prevalence of antifungal resistance in Candida spp from patients with AIDS.
        J Antimicrob Chemother. 1994; 34: 659-668
        • Wingard JR
        • Merz WG
        • Rinaldi MG
        • Johnson TR
        • Karp JE
        • Saral R
        Increase in Candida krusei infection among patients with bone marrow transplantation and neutropenia treated prophylactically with fluconazole.
        N Engl J Med. 1991; 325: 1274-1277
        • Nyirjesy P
        • Seeney SM
        • Terry Grody MH
        • Jordan CA
        • Buckley HR.
        Chronic fungal vaginitis: the value of cultures.
        Am J Obstet Gynecol. 1995; 173: 820-823
        • Odds FC.
        Candida and candidosis.
        2nd ed. Balliere Tindall, London1988
        • Redondo-Lopez V
        • Lynch M
        • Schmitt C
        • Cook R
        • Sobel JD
        Torulopsis glabrata vaginitis: clinical aspects and susceptibilities to antifungal agents.
        Obstet Gynecol. 1990; 76: 651-655
        • Spinillo A
        • Capuzzo E
        • Egbe TO
        • Baltaro F
        • Nicola S
        • Piazzi G
        Torulopsis glabrata vaginitis.
        Obstet Gynecol. 1995; 85: 993-998
        • Johnson EM
        • Warnock DW
        • Luker J
        • Porter SR
        • Scully C
        Emergence of azole drug resistance in Candida species from HIV-infected patients receiving prolonged fluconazole therapy for oral candidosis.
        J Antimicrob Chemother. 1995; 35: 103-114
        • Denning DW.
        Can we prevent azole resistance in fungi?.
        Lancet. 1995; 346: 454-455