Candida glabrata with special reference to European epidemiology. Review and presentation of new data

P. A. Mårdh, I. Sziller, V. Tolbert, N. Novikova, K. Kristof, A. G. Rodrigues, C. Pina-Vaz, J. Martinez-de-Oliveira

Research output: Contribution to journalReview article

3 Citations (Scopus)

Abstract

Objective: To review published data on the prevalence of Candida glabrata in cohorts of pregnant and non-pregnant women and to present new own observations and to test the antifungal susceptibility of isolates of C. glabrata. Materials and methods: Vaginal colonization of 1589 non-pregnant women by C. glabrata was studied in 947 German, 438 Hungarian, 91 Portuguese, 113 Ukrainian women, and in 611 second trimester pregnant Swedish women, 256 of whom were retested in the third trimester. Vaginal content was studied by Amsel's criteria and stained vaginal smears for bacterial morphotypes. Candida cultures were made on Sabouraud and Chromagar, speciation on Chromagar, by API kits and Vitek™. C. glabrata was tested for susceptibility to ketoconazole, itraconazole, fluconazole, caspofungine, voriconazole and amphotericin B. Results: Of the German women attending with various infections vaginal conditions, 249 (26.3%) harboured a Candida spp., 55 (22.1%) of which proved to be C. glabrata. Of the Hungarian women referred as RVVC cases, 147 (34.0%) yielded a Candida spp., 12 (8.2%) were C. glabrata. Of the 91 Candida culture-positive Portuguese RVVC cases, 5 (5.5%) were colonized by C. glabrata. Of the Ukrainian women assumed to suffer from RVVC, only 57 (50.4%) had a positive candida-culture, 3 (5%) harboured C. glabrata. Of the Swedish women, 127 (20.1%) were culture-positive for Candida spp. in the second trimester as well as 48 (19.0%) of those who returned. C. glabrata was recovered from 24 (3.9%) and 7 (2.7%) at these occasions. Only 5 (0.4%) of all women had double infection with Candida spp.; four with C. glabrata. Six of 12 Hungarian C. glabrata strains were resistant to 32 μg/ml of itraconazole and amphotericin B. Of 23 Swedish isolates, all were resistant to ketoconazole, 5 (22%) to 4 μg/ml and 14 (61%) to 64 μg/ml of fluconazole. Strains tested were highly sensisitve to caspofungine and voriconazole, i.e. to </ = 0.06-0.125 μg/ml and 0.125-0.250 μg/ml, respectively. Conclusions: A large proportion of women assumed to suffer from RVVC, cannot be confirmed as candida-carriers. In pregnant women, C. glabrata constitutes a notable high proportion of Candida isolates. Double infection with C. glabrata is uncommon. The susceptibility of drugs used to treat RVVC is unpredictable. Caspofungine and voriconazole, may become useful in therapy-resistent infections with C. glabrata. The study highlights the potential value of speciation and susceptibility testing vaginal isolates of Candida.

Original languageEnglish
Pages (from-to)73-80
Number of pages8
JournalItalian Journal of Gynaecology and Obstetrics
Volume17
Issue number2
Publication statusPublished - Jan 1 2005

Keywords

  • Antifungal susceptibility
  • Candida glabarta
  • European epidemiology
  • Recurrent vulvovaginal candidosis
  • Vulvovaginal candidosis

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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    Mårdh, P. A., Sziller, I., Tolbert, V., Novikova, N., Kristof, K., Rodrigues, A. G., Pina-Vaz, C., & Martinez-de-Oliveira, J. (2005). Candida glabrata with special reference to European epidemiology. Review and presentation of new data. Italian Journal of Gynaecology and Obstetrics, 17(2), 73-80.