Attributes of microorganisms that contribute to recurrence and intractability of vaginal mycosis

Recurrence or intractability of vaginal mycosis may be ascribable to various factors. Attributes of microorganisms that contribute to recurrence and intractability of vaginal mycosis have not fully been elucidated. We studied this problem by means of a modern fungal identification method, strict measurement of the minimum inhibitory concentration and close clinical analysis. As for the detection rate for Candida albicans (C. alb.) and Torulopsis glabrata (T. glab.) as pathogens of vaginal mycosis, we found a relative increase was observed in T. glab. that so far has shown strong adaptability, even under unfavorable environments, to general fungi. The MIC values for clotrimazole (CTZ) against T. glab. were about 4 times as high as those against C. alb. No acquired resistance to CTZ was observed in these 2 groups. Conventional identification methods have been unable to provide conclusive evidence of the self-infection of vaginal mycosis from the anus to the vagina via the vulva. In some of the cases examined in this study, the modern fungal identification method succeeded in demonstrating that the fungal species detected in these three regions were of the same origin. Some of the C. alb. and T. glab. strains which reappeared after treatment were found to be different from those detected before treatment, a finding indicating that reinfection, apart from recurrence, occurred. Besides, treatment occasionally resulted in replacement of C. alb. with T. glab.