ABSTRACT
Background: Candidial balanitis, balanoposthitis and vulvovaginitis can be diagnosed by direct microscopy, culture and treated with antifungals. Resistance to antifungals is emerging. Hence, we conducted a study to identify the causative species and antifungal susceptibility. Aim: To observe the species differentiation and antifungal susceptibility pattern in patients with genital candidiasis. Materials and Methods: A prospective observational study was carried out that included 54 patients of age group (18-60 years) diagnosed clinically and direct microscopically (KOH) for genital candidiasis. Culture was done using Sabouraud dextrose agar. Species identification and antifungal susceptibility were tested. Descriptive data were expressed in the form of frequency and percentage. Results: Out of 54 patients, 41 had culture positive candidiasis. Among the isolated species, 68.3% were Candida albicans (28/41) and 31.7% were non- albicans Candida spp. Among non-albicans Candida species (13/41), Candida glabrata (19.5%), Candida tropicalis (7.3%), Candida guilliermondii (2.4%), Candida parapsilosis (2.4%) were identified. Antifungal susceptibility was tested for fluconazole (FLU), clotrimazole (CLTZ), itraconazole (ITZ), ketoconazole (KTZ), voriconazole (VOR), amphotericin-B (AMPH-B). Except C. glabrata and C.parapsilosis, all other species were sensitive to all tested antifungals. All isolated species were sensitive to KTZ, VOR, AMPH-B, and CLTZ. Nearly 22% of isolates were resistant to fluconazole. Conclusion: C. glabrata causes complicated, severe recurrent vulvovaginitis which is fluconazole resistant. Drug sensitivity prior prescribing antifungal agent identifies appropriate drug, decreases patient's disease morbidity and cross resistance.
ABSTRACT
Candidal balanitis typically affects sexually active adult males and may present as eroded papules, pustules, whitish discharge or erythema with dry glazed appearance. We report an unusual presentation of this common infection in an uncommon demographic, candidal balanitis presenting as coalescent vesicles and erosions arranged in an arcuate pattern in a pre-school child.
Subject(s)
Balanitis , Candidiasis, Cutaneous , Candidiasis , Adult , Balanitis/diagnosis , Balanitis/drug therapy , Child, Preschool , Humans , MaleABSTRACT
Anogenital skin care for the elderly remains an umbrella term concerning protective and non-interventional regimens, particularly for ordinary diaper users. Our recent investigation has demonstrated the preventive effect of daily anogenital washing with miconazole nitrate-containing soap to the development of diaper candidiasis. We extended this work to cover our hypothesis as to whether the miconazole soap has a therapeutic benefit in genital candidiasis. The study outline includes: (i) the enrollment of 21 bedridden inpatients (84 ± 9 years; eight men and 13 women) who were diagnosed clinically and mycologically with genital candidiasis, and who had never received topical and/or systemic antifungal agents; (ii) administration of anogenital washing with 0.75% miconazole-containing soap once daily for 4 weeks; and (iii) assessment of clinical symptoms and detection of Candida materials by culture and microscopic examination. As assessed by clinical symptom scoring for incontinence-associated dermatitis (IAD), the ratio of patients with severe to moderate symptoms dramatically decreased by 2 weeks and 10 of 21 patients became symptom-free at 4 weeks. The IAD clinical severity score was significantly decreased at 4 weeks. Compared with the baseline positivity, both microscopic and cultured Candida-positive rates were significantly decreased at 4 weeks after washing. All culture-detected fungi were Candida albicans. Severe adverse events did not occur in all participants. Individual medical and risk factors had no significant correlation with clinical severity and duration of candidiasis on variance analysis. In conclusion, topical washing with miconazole soap is a safe and reliable non-medical approach for soothing diaper-associated genital candidiasis in bedridden inpatients in whom it is difficult to perform prompt medical examination.
Subject(s)
Antifungal Agents/administration & dosage , Candidiasis, Cutaneous/therapy , Candidiasis, Vulvovaginal/therapy , Diaper Rash/therapy , Skin Care/methods , Soaps/therapeutic use , Aged , Aged, 80 and over , Candida/isolation & purification , Candidiasis, Cutaneous/diagnosis , Candidiasis, Cutaneous/microbiology , Candidiasis, Vulvovaginal/diagnosis , Candidiasis, Vulvovaginal/microbiology , Diaper Rash/diagnosis , Diaper Rash/microbiology , Diapers, Adult/adverse effects , Female , Humans , Male , Miconazole/administration & dosage , Prospective Studies , Severity of Illness Index , Soaps/chemistry , Treatment Outcome , Urinary Incontinence/therapyABSTRACT
OBJECTIVE To investigate species and drug resistance of pathogenic fungi from patients with urogenital candidiasis.METHODS The fungi were cultured with general method,isolated and identified with CHRO-Magar medium and API20C AUX stripes.Drug sensitive test was tested by M-27-A broth microdilution method recommendated.RESULTS In 331 pathogenic fungi,C.albicans was the most frequent species,followed by C.glabrata and C.parapsilosis.The resistant rate in the female patients was:to itraconazole 3.24%,fluconazole 4.32%,nystatin 4.86%, amphotericin B 6.49%,miconazole 16.76%,ketoconazole 17.84%,and to econazole 28.6%,and that in the male patients was:to nystatin 4.11%,itraconazole 5.48%,fluconazole 8.22%,amphotericin B 10.27%,ketoconazole 17.81%,econazole 23.29% and to miconazole 26.71%.CONCLUSIONS In order to guide clinically the selection of reasonable antifungals,species identification and sensitive test should also be stressed.