The case of infectious. Comparative study of the in vitro sensitivity to antifungals of candida albicans strains isolated from patients with chronic vaginitis

Abstract

In the present study we analyzed the MIC's and the MLC's of 20 C. albicans isolates obtained from patients with acute and cronic vaginitis; antimycotics and concentrations tested were amphotericin B (0.03 -16 µ/mi), ketoconazole (0.03 -16 µ/mi), fluconazole(0.125 -64 µ/mi) and itraconazole (0.018 -10 µ/mi). The technique used was the macro-dilution procedure recommended by the NCCLS. Results indicated that the MIC's of all isolates, acute and crhonic, fall in the range of sensirivity indicated for the test and that even the lowest concentrations used, proved inhibitory. Contrariwise, none of the isolates achieved MLC values with fluconazole or itraconazole; half of the C. albicans isolates from the acute, and falf from the chronic cases, were killed by ketoconazole; a higher proportion of isolates (75% acute, 90% chronic), also reached MLC's values with amphotericin B. It appears then, that chronicity and recurrence are not due to resistance to the antimycotics used for therapy of these disorders. Most of the antimycotics are fungistatic and the host's immune response is needed to overcome the infection; consequently, treament failures could also be attributed to the patient itself. Nonetheless, high MLC's values may suggest a change of drug or a combination of drugs, in order to have morepossibilities of success.