Frequency and significance of drug resistance in vulvovaginal candidiasis

The rates of non-albicans species and susceptibility to the main antimycotic drugs were evaluated in a series of 472 cultures of vulvar or vaginal specimens positive for Candida species. Torulopsis glabrata was associated more frequently than C. albicans with recurrent vulvovaginal candidiasis (18/40 vs. 72/379; p = 0.003, chi 2 test). As evaluated by the results of susceptibility testing, C. albicans isolates were uniformly sensitive to the antifungals tested, whereas 7.5% (3/40) of T. glabrata strains were resistant to imidazole derivatives. All these patients had a history of repeated antimycotic treatments. Previous antimycotic therapies in susceptible individuals could cause a selection of non-albicans species, especially T. glabrata, which is occasionally resistant to the commonly used antimycotic drugs.