Accuracy in clinical examinations for the diagnosis of vulvovaginitis by Candida ssp. and In vitro susceptibility to the main antifungals
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Data
2020-09-29
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Universidade Federal de Goiás
Resumo
Vulvovaginal candidiasis (VVC) is a common infection. This work aims to determine the positive
predictive value (PPV) of the clinical diagnosis of VVC and to characterize Candida species
isolated from the vaginal mucosa. This cross-sectional study was conducted from February
2016 to February 2017 at the Gynecology and Obstetrics Outpatient Clinic of the Hospital
das Clínicas, in Goiânia, Goiás State, Brazil. The study included samples of vaginal secretion
from 55 women who complained of vaginal discharge and itching as their main symptoms. The
PPV of the clinical diagnosis of VVC was estimated in comparison to the laboratory culture
method. The phenotypic methods and molecular tests were performed to identify Candida
spp. In vitro susceptibility of Candida spp. isolates to fluconazole, itraconazole, clotrimazole,
nystatin, and amphotericin B was determined using the broth microdilution assay. Yeast growth
using the enzymes protease, phospholipase, and hemolysin was carried out in media containing
respectively bovine albumin, egg yolk, and sheep erythrocytes. A PPV of 61.8% (34/55) was
determined. Among the 55 vulvovaginal samples collected, we identified 36 isolates in which
C. albicans was the most common species. High resistance to fluconazole and low minimal
inhibitory concentration (MIC) values for clotrimazole, nystatin and amphotericin B were
observed. All isolates were proteinase and hemolysin producers, while seven strains were
phospholipase negative. The clinical diagnosis of VVC presented a moderate PPV, which meant
that cultures had to be conducted in the laboratory to confirm infection. The high resistance to
fluconazole and itraconazole indicated the importance of the in vitro susceptibility test.
Descrição
Palavras-chave
Vulvovaginal candidiasis, Antifungal susceptibility, Enzymatic activity
Citação
SANTOS, Andressa Santana; ZARA, Ana Laura Sene Amâncio; ATAÍDES, Fábio Silvestre;SILVA, Elisangela Gomes da; FREITAS,Vivianny Aparecida Queiroz; COSTA,Carolina Rodrigues; SILVA, Thaísa Cristina; DO SILVA, Maria do Rosário Rodrigues. Accuracy in clinical examinations for the diagnosis of vulvovaginitis by Candida ssp. and In vitro susceptibility to the main antifungals. Revista de Patologia Tropical, Goiânia, v. 49, n. 3, july/Sept. 2020. Disponível em: https://www.revistas.ufg.br/iptsp/article/view/64233.