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.)
Keywords
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References
- Vaginal infections in adult women.Med Clin North Am. 1990; 74: 1573-1601
- Mycotic vulvovaginitis: a broad overview.Am J Obstet Gynecol. 1991; 165: 1188-1192
- Vulvovaginal candidiasis: an overview.Acta Derm Venereol. 1986; 121: 39-46
- Candidal vulvovaginitis.Clin Obstet Gynecol. 1993; 36: 153-165
- High prevalence of antifungal resistance in Candida spp from patients with AIDS.J Antimicrob Chemother. 1994; 34: 659-668
- 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
- Chronic fungal vaginitis: the value of cultures.Am J Obstet Gynecol. 1995; 173: 820-823
- Candida and candidosis.2nd ed. Balliere Tindall, London1988
- Torulopsis glabrata vaginitis: clinical aspects and susceptibilities to antifungal agents.Obstet Gynecol. 1990; 76: 651-655
- Torulopsis glabrata vaginitis.Obstet Gynecol. 1995; 85: 993-998
- 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
- Can we prevent azole resistance in fungi?.Lancet. 1995; 346: 454-455
Article Info
Publication History
Accepted:
August 19,
1996
Received in revised form:
July 3,
1996
Received:
June 11,
1996
Footnotes
☆From the Departments of Obstetrics and Gynecologya and Infectious Diseases,b Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo.
☆☆Reprint requests: Arsenio Spinillo, MD, Clinica Ostetrico-Ginecologica, IRCCS Policlinico San Matteo, Piazzale Golgi 2, 27100 Pavia, Italy.
★6/1/77419
Identification
Copyright
© 1997 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
