Pathogenic and treatment study on vulvovaginal candidiasis in pregnancy / 中华围产医学杂志

ABSTRACT

Objective To determine the prevalence of vulvovaginal candidiasis(VVC) in pregnant women,to test its antifungal susceptibility to miconazole,clotrimazole,fluconazole, itrocona- zole,and nystatin and to treat VVC with miconazole in pregnancy. Methods Vaginal swabs were collected from unselected pregnant women in prenatal clinic. The antifungal susceptibility of 131 strains of Candidas to miconazole,clotrimazole,fluconazole,itroconazole,and nystatin were detected by Neo-Sensitabs susceptibility testing. 66 cases of VVC were treated with 6 day-course of miconazole(400 mg/d). Results The prevalence of VVC in pregnant women was 12.7%(127/1000). 37.4%(374/1000) had previous VVC. 0.6%(6/1000)of women were recurrent VVC(RVVC),which occupied 4.7%(6/127) of VVC. C. albicans was the most frequently(87.1%) isolated pathogen followed by C. glabrata (9.9%) ,C. tropicalis(1.5%),and C. krsei(1.5%). The resistant rate of C. albicans to miconazole,clotrimazole,fluconazole,itroconazole,and nystatin was 10.5%、2.6%、 6.1%、 7.9%,and 0. All 13 strains of C. glabrata was susceptible to miconazole,nystatin and susceptible or susceptible-dependent-upon-dose (SDD) to clotrimazole,fluconazole,and itroconazole. The mycological cure rate of miconazole on day 7～14 and day 28～42 was 84.8%(56/66 cases) and 80.3% (53/66 cases). Conclusions VVC is very common in pregnancy. C. albicans is the predominant Candida species in VVC and has some resistance to miconazole,clotrimazole,fluconazole,itroconazole,and nystatin. Miconazole therapy is effective on VVC treatment in pregnant women. Non-effective treatment might be associated with Candidas resistance.