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.