Abstract
The trends of species structure and susceptibility of yeast-like fungi to antimycotics, isolated from genital tract of women with vulvovaginal candidiasis (n=2828) in 1997–2003 were studied. There was found a tendency to increase in the rate of fungi isolation from 14 to 20%. The predominant species was C. albicans (83.7–86%). Non-albicans species were isolated in 14–16.3%. Among them, the most frequently isolated species were С. glabrata (35.3%), C. krusei (19.0%), C. parapsilosis (14.2%). Using the «Fungitest» system, it was shown that the number of fungi strains susceptible to 6 antimycotics was decreased in C. albicans from 71.6% at the beginning of monitoring period to 48.2% at the end of this one; in non-albicans species – from 60% to 19.2%, respectively. A total number of non-susceptible isolates (resistant and susceptible dose-dependent) was increased. At the same time, 80.4–92.9% strains of C. albicans and 80,0-100% strains of С. parapsilosis and C. kefyr were susceptible to imidazoles (miconazole and ketoconazole) and triazoles (itraconazole, fluconazole). As to emerging species (С. glabrata, C. krusei, C. tropicalis), a number of susceptible strains to these drugs was less than 50%. A comparison of emerging species (С. glabrata, C. krusei) resistance to triazoles showed the advantage of itraconazole to fluconazole solely for C. krusei: 31.3% and 37.0% of strains were susceptible and 60% and 15.6% were dose-dependent to itraconazole and fluconazole, respectively. In contrast, 76% of C. glabrata strains were susceptible to fluconazole and only 24% of strains to itraconazole. Therefore, the majority of emerging species were susceptible dose-dependent to antimycotics and it can be overcome by the use of increased therapeutic dose.
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