Prevalence of vulvovaginal candidiasis and susceptibility to fluconazole in women

OBJECTIVE: The purpose of this study was to determine the prevalence of vaginal colonization by Candida with the use of a rapid detection method, to examine the determinants of vaginal candidiasis, and to evaluate susceptibility for fluconazole. STUDY DESIGN: Vaginal swabs were collected from unselected women at the outpatient clinic of the Department of Obstetrics and Gynecology. A differentiation was made between patients with a positive and a negative potassium hydroxide examination. RESULTS: Six hundred twelve women were recruited, of whom 39 women (6.3%) had clinical candidiasis. The overall rate of yeast colonization was 20.1%. Candida albicans was isolated most frequently(68.3%), followed by C glabrata (16.3%) and C parapsilosis (8.9%). Clinical candidiasis was related positively with the state of estrogen impregnation. In vitro susceptibility testing by the National Committee for Clinical Laboratory Standards method for fluconazole revealed that 21.1% of the isolates were resistant. CONCLUSION: More than 20% of the unselected women were colonized with Candida species. Hyperestrogenemia was associated with an increased vulvovaginal colonization by Candida. Surprisingly, 21% of the isolates was resistant to fluconazole, according to the National Committee for Clinical Laboratory Standards method.