Volume 16, Issue 1 (3-2022)
payavard 2022, 16(1): 61-70 |
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Vahedpoor Z, Azadchehr M J, Baghbani T, Felfelian Fini T, Nazeri M. Therapeutic Response and Antifungal Susceptibility to Fluconazole in Women with Vulvovaginal Candidiasis. payavard 2022; 16 (1) :61-70
URL: http://payavard.tums.ac.ir/article-1-7212-en.html
URL: http://payavard.tums.ac.ir/article-1-7212-en.html
Zahra Vahedpoor1 
, Mohammad Javad Azadchehr2 , Taha Baghbani3 , Tayebeh Felfelian Fini4 , Mehdi Nazeri * 5
, Mohammad Javad Azadchehr2 , Taha Baghbani3 , Tayebeh Felfelian Fini4 , Mehdi Nazeri * 5
1- Assistant Professor, Autoimmune Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran
2- Master of Science in Biostatistics, Infectious Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran
3- General Medicine Student, Student Research Committee, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
4- Bachelor of Science in Midwifery, Shahid Beheshti Hospital, Kashan University of Medical Sciences, Kashan, Iran
5- Assistant Professor, Department of Parasitology and Mycology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran ,nazeri_me@kums.ac.ir
2- Master of Science in Biostatistics, Infectious Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran
3- General Medicine Student, Student Research Committee, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
4- Bachelor of Science in Midwifery, Shahid Beheshti Hospital, Kashan University of Medical Sciences, Kashan, Iran
5- Assistant Professor, Department of Parasitology and Mycology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran ,
Abstract: (1628 Views)
Background and Aim: Vulvovaginal candidiasis (VVC) is a vaginal fungal infection that mainly caused by Candida albicans. Among various treatments and their controversial outcomes, oral fluconazole has been accepted as a common and efficient treatment for acute and chronic cases. The aim of this study is about therapeutic effect of fluconazole and evaluation of its antifungal susceptibility.
Materials and Methods: In this cross-sectional study Samples were collected from 107 suspected patients to vulvovaginal candidiasis who went to the gynecology clinic of Kashan University of Medical Sciences in (2020-2022). At first consent and then demographic registrations were obtained. All samples were collected and cultured on Chromagar and Sabouraud’s dextrose agar and incubated at 30°C for 72 h. Yeast colonies were identified based on their colors and morphologic criteria.
All patients were treated by a single dose of fluconazole (150 mg/ml) or two continuous additional doses, depending on the absence or history of recurrence. Improvement of clinical and mycological symptoms in patients were followed for 30-35 days. Antifungal susceptibility to fluconazole was determined by microdilution method (CLSI, document M27-A3).
Results: A total of 107 patients were diagnosed with vulvovaginal candidiasis. Candida albicans (79.4%) was the most common identified species. total response to fluconazole treatment based on mycological findings (negative culture and direct smear) was 62.6% (P=0.012), there was no significant difference between candida species, albicans (64.7%) and non-albicans (54.5%), type of vaginal candidiasis forms (recurrent and non-recurrent) and antifungal susceptibility to fluconazole (MIC≤8)(P>0.05). Consideration of MICs≤1 and MICs>1 as a cutoff point there was a significant difference between failure and response to treatment (P=0.014).
Conclusion: According to empiric treatment of Vulvovaginal candidiasis, concurrent Laboratory diagnosis with anti-fungal susceptibility could help us in selecting the appropriate treatment protocol and prevent the emergence or increase of resistant species.
Materials and Methods: In this cross-sectional study Samples were collected from 107 suspected patients to vulvovaginal candidiasis who went to the gynecology clinic of Kashan University of Medical Sciences in (2020-2022). At first consent and then demographic registrations were obtained. All samples were collected and cultured on Chromagar and Sabouraud’s dextrose agar and incubated at 30°C for 72 h. Yeast colonies were identified based on their colors and morphologic criteria.
All patients were treated by a single dose of fluconazole (150 mg/ml) or two continuous additional doses, depending on the absence or history of recurrence. Improvement of clinical and mycological symptoms in patients were followed for 30-35 days. Antifungal susceptibility to fluconazole was determined by microdilution method (CLSI, document M27-A3).
Results: A total of 107 patients were diagnosed with vulvovaginal candidiasis. Candida albicans (79.4%) was the most common identified species. total response to fluconazole treatment based on mycological findings (negative culture and direct smear) was 62.6% (P=0.012), there was no significant difference between candida species, albicans (64.7%) and non-albicans (54.5%), type of vaginal candidiasis forms (recurrent and non-recurrent) and antifungal susceptibility to fluconazole (MIC≤8)(P>0.05). Consideration of MICs≤1 and MICs>1 as a cutoff point there was a significant difference between failure and response to treatment (P=0.014).
Conclusion: According to empiric treatment of Vulvovaginal candidiasis, concurrent Laboratory diagnosis with anti-fungal susceptibility could help us in selecting the appropriate treatment protocol and prevent the emergence or increase of resistant species.
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