Acta Scientiarum. Health Sciences Maringá, v. 25, no. 1, p. 51-54, 2003 In vitro activity of antifungal agents on yeasts isolated from vaginal secretion Rubia Andreia Falleiros de Pádua, Eliana Guilhermetti and Terezinha Inez Estivalet Svidzinski* Departamento de Análises Clínicas, Universidade Estadual de Maringá, Av. Colombo, 5790, 87020-900, Maringá, Paraná, Brasil. *Author for correspondence. e-mail: tiesvidzinski@uem.br or terezinha@email.com ABSTRACT. Vulvovaginal candidiasis (VVC) is the second most frequent cause of vaginal infection, having high incidence and recurrence, which requires longer treatments. The genus Candida, specially the species C. albicans, is the most common agent. However, other species, more difficult to eradicate, may also be involved. The aim of this study was to determine the frequency of vaginal colonization by yeasts and to evaluate susceptibility to three drugs, which are indicated for the VVC treatment. Vaginal secretion was collected from four hundred and twelve unselected women. The overall rate of yeast colonization was 20.15%. Candida albicans was the most frequent (84%), followed by C. glabrata (7%), C. tropicalis (4%), Torulopsis sp (2%), C. parapsilosis (2%) and S. cerevisiae (1%). In vitro susceptibility tests revealed that 96,4% of the isolated yeasts were susceptible to fluconazole, 71% to nistatin and 98,8% to amphotericin B. Key words: Candida sp., vulvovaginal colonization, antifungal drugs, susceptibility test. RESUMO. Atividade in vitro de agentes antifúngicos sobre leveduras isoladas de secreção vaginal. Candidíase vulvovaginal (CVV) é a segunda causa de infecção vaginal e apresenta alta incidência da forma recorrente, o que resulta em tratamentos prolongados. O gênero Candida, principalmente a espécie C. albicans, é o agente mais comum. Entretanto, outras espécies mais difíceis de serem erradicadas podem também estar envolvidas. A proposta deste estudo foi determinar a freqüência de colonização vaginal por leveduras e avaliar a susceptibilidade a três drogas indicadas para tratamento de CVV. Foram coletadas amostras de secreção vaginal de quatrocentas e doze mulheres, não triadas. A taxa total de colonização por leveduras foi de 20,15%. Candida albicans foi a mais freqüente (84%), seguida por C. glabrata (7%), C. tropicalis (4%), Torulopsis sp (2%), C. parapsilosis (2%) e S. cerevisiae (1%). Testes de susceptibilidade in vitro revelaram que 96,4% dos isolados foram considerados susceptíveis ao fluconazol, 71% à nistatina e 98,8% à anfotericina B. Palavras-chave: Candida sp., colonização vulvovaginal, drogas antifúngicas, teste de susceptibilidade. Introduction Vulvovaginal candidiasis (VVC) is the second most frequent cause of vaginal infection (Osset et al., 2001). It is estimated that 90% of vulvovaginal candidiasis cases are attributed to Candida albicans. The remaining cases have the non-albicans species as causal agents, being Candida glabrata and Candida tropicalis the most common ones (Sobel, 1996). It is estimated that at least 75% of all women develop one episode of VVC at some time in their lives (Saporiti et al., 2001) and the recurrence rate is high (Sobel, 1996). On the other hand, 20 to 25% of the women in child-bearing age have vaginal colonization by yeast (Redondo-Lopez et al., 1990). The presence of yeast as colonization is the basis for infection development. The other species called non-albicans are more difficult to eradicate (Gupta and Bluhm, 2002). It has been evident that there are differences in the susceptibility pattern to the antifungal drugs among different species, what is relevant to the clinical and epidemiological point of view (Odds, 1996). In vitro studies have demonstrated that most of non-albicans species from vaginal secretion have sensibility reduced in relation to Candida albicans, for both topical and systemic antifungal drugs (Lynch and Sobel, 1994). The emergence of a large diversity of fungus considered pathogenic up to this moment can be a consequence of the increasing use of the azoles antifungicals, specially fluconazole, which may incite the more resistant yeasts, Candida non-albicans, to emerge by suppression of the normal endogenous