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Antimicrobial Resistance in Vulvovaginitis

Jack D. Sobel1

  • 1Division of Infectious Diseases, Harper Hospital, 3990 John R, Detroit, MI 48201, USA. jsobel@intmed.wayne. edu

Current Infectious Disease Reports
|November 28, 2001
PubMed

Insights

Antimicrobial resistance in vaginal infections is understudied. While bacterial vaginosis, candidiasis, and trichomoniasis resistance are rare, azole misuse may increase resistant Candida strains like Candida glabrata.

Area of Science:

  • Medical Mycology
  • Antimicrobial Resistance
  • Vaginal Infections

Background:

  • Antimicrobial resistance significantly impacts clinical medicine, yet its role in vaginal infections is largely unexplored.
  • Current evidence does not strongly link frequent relapses of bacterial vaginosis or vulvovaginal candidiasis to antimicrobial resistance.
  • Metronidazole-resistant trichomoniasis is exceptionally rare.

Purpose of the Study:

  • To investigate the current state of antimicrobial resistance in common vaginal infections.
  • To explore the potential impact of antimicrobial agent misuse on resistance patterns in vaginal fungi.

Main Methods:

  • Review of existing literature on antimicrobial resistance in bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis.
  • Analysis of the potential for resistance development due to over-the-counter and systemic azole use.

Main Results:

  • Limited evidence suggests antimicrobial resistance is not a primary driver for relapses in bacterial vaginosis or vulvovaginal candidiasis.
  • Metronidazole resistance in trichomoniasis remains uncommon.
  • Potential for increased azole resistance in Candida albicans and intrinsic azole resistance in non-albicans species (e.g., Candida glabrata) due to widespread azole exposure.

Conclusions:

  • Antimicrobial resistance is not a significant factor in common vaginal infections currently.
  • Widespread use of azoles may promote the emergence of azole-resistant Candida species, particularly non-albicans strains like Candida glabrata.
  • Further surveillance of resistance patterns in vaginal mycoses is warranted.

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