Background

Recurrent vulvovaginitis is a growing problem that affects millions of women worldwide. In many cases it is treated as vulvovaginal candidiasis, but there is not always microbiological confirmation.

Aims

To determine the etiology of vulvovaginitis in a group of patients.

Methods

This is a cross-sectional study in which the data from the medical records of 316 adult patients who consulted for vulvovaginitis were analyzed. Eighty nine percent of the cases had already suffered previous episodes.

Results

The median age was 34 (265 patients were between 16 and 45 years old). Yeasts were isolated in culture from 211 (66.8%) patients, although pseudo-hyphae and yeasts were observed in only 166 samples (52.5%) in the direct microscopic examination. Multiple predisposing factors were found, among which the use of contraceptives or previous antibiotics stand out. Most of the patients (almost 90%) had been treated with antifungals, with or without microbiological confirmation. Candida albicans was isolated in 187 (88.6%) patients, followed by Candida glabrata in 6 (2.8%) patients. Association with bacterial vaginosis was found in 35.1% and with intermediate bacterial microbiota in 33.2% of the cases. A remarkably high proportion of C. albicans isolates resistant to fluconazole (80.1%) and itraconazole (58.8%) was found.

Conclusions

A microbiological analysis is essential to confirm the diagnosis of vulvovaginal candidiasis, whether simple, complicated, or recurrent. Identifying the isolated yeast species and determining its susceptibility to antifungal agents are particularly important.

中文翻译：

---

慢性复发性外阴阴道炎不仅是念珠菌引起的

背景

复发性外阴阴道炎是一个日益严重的问题，影响着全世界数百万妇女。在许多情况下，它被视为外阴阴道念珠菌病，但并不总是得到微生物学证实。

宗旨

确定一组患者外阴阴道炎的病因。

方法

这是一项横断面研究，其中分析了 316 名因外阴阴道炎就诊的成年患者的医疗记录数据。89% 的病例已经经历过之前的发作。

结果

中位年龄为 34 岁（265 名患者的年龄在 16 至 45 岁之间）。从 211 名 (66.8%) 患者的培养物中分离出酵母菌，尽管在直接显微镜检查中仅在 166 个样品 (52.5%) 中观察到假菌丝和酵母菌。发现了多种诱发因素，其中使用避孕药或既往抗生素最为突出。大多数患者（近 90%）都接受过抗真菌药物治疗，无论是否经过微生物学确认。白色念珠菌分离在187（88.6％）患者，随后光滑念珠菌6（2.8％）的患者。35.1% 的病例与细菌性阴道病有关，33.2% 的病例与中间细菌微生物群有关。白色念珠菌的比例非常高 发现对氟康唑 (80.1%) 和伊曲康唑 (58.8%) 耐药的分离株。

结论

微生物分析对于确认外阴阴道念珠菌病的诊断至关重要，无论是简单的、复杂的还是复发的。鉴定分离的酵母种类并确定其对抗真菌剂的敏感性尤为重要。