Recurrent Vulvovaginal Candidiasis: clinical features, resistant patterns and response to treatment

CAEIRO, JUAN PABLO; MIRÓ, MARÍA SOLEDAD; RODRÍGUEZ, EMILSE; VARGAS, LARA; ABIEGA, CLAUDIO; VIGEZZI, CECILIA; ICELY, PAULA ALEJANDRA; RIERA, FERNANDO OSCAR; CLAUDIA ELENA SOTOMAYOR

Buenos Aires

Congreso; 18th International Congress on Infectious Diseases (ICID); 2018

Sociedad Argentina de Infectología

Background: Recurrent vulvovaginal candidiasis (RVVC) is a condition difficult to manage that affects 5 to 10% of healthy childbearing age women. It is not apparent what the underlying cause of RVVC is. Our aim was to evaluate the clinical features, Candida species distribution, resistant patterns and the response to treatment in health women who suffer RVVC. We also attempt to describe local immune response changes.Methods & Materials: 79 patients with RVVC who had four or more symptomatic episodes per year, were enrolled in the study. Time curse of infection, risk factors, treatment and its efficiency were evaluated. Clinical isolates were identified by MALDI TOF and antifungal susceptibility to Amphotericin B, Fluocytosine, Voriconazole and Fluconazole by Vitek2 Compact. Dectin-1 and IL-1b expression in vaginal epithelial cells recovered from patients were evaluated by qPCR. Results: The time course of RVVC in the patients was: 1 year or less, 42%; between 2 and 3 years, 52%; > or = 5 years, 3.9% and 2.1% < or = 10 years. 58% didn?t have any risk factors, 35% contraceptive usage, 4.5% antibiotics therapy and 2.7% mixed factors. Yeast identification revealed that from all isolated strains 95,6% were C. albicans, 2.7% C. guilliermondii and 1.5% C. glabrata. All strains were sensitive to Amphotericin-B and Fluocytosine, meanwhile 23.7% were resistant to Fluconazole and 4.7% to Voriconazole. The efficacy of treatment was 69%. Different profiles of expression of Dectin-1 and IL-1_ between patients with RVVC were observed. Conclusion: The present study provides relevant information about different clinical aspects of RVVC. The study is useful to help manage this condition.