This research paper investigates the increasing prevalence of fluconazole resistance among yeast isolates from women diagnosed with recurrent vulvovaginal candidiasis in Leeds, England.
Bibliographic Information: Ratner, J. C., Wilson, J., Roberts, K., Armitage, C., & Barton, R. C. (2023). Fluconazole resistance in vulvovaginal yeasts increases. Sexually Transmitted Infections. Published online August 9, 2023.
Research Objective: To analyze the trends in fluconazole resistance among yeast isolates causing recurrent vulvovaginal candidiasis in Leeds, England, between April 2018 and March 2021.
Methodology: Researchers retrospectively analyzed 5,461 vaginal culture samples from women diagnosed with complicated/recurrent vulvovaginal candidiasis. Species identification and antifungal susceptibility testing were performed using WASPLAB automated platform, Matrix-assisted laser desorption ionization–time-of-flight mass spectrometry, disc diffusion, and the Sensititre YeastOne microbroth dilution assay.
Key Findings:
Main Conclusions: The study highlights a concerning rise in fluconazole resistance and non-albicans Candida species in recurrent vulvovaginal candidiasis cases, potentially linked to increased empirical treatment following restricted access to fungal cultures for diagnosis in primary care.
Significance: The findings emphasize the need to re-evaluate the practice of empirical treatment for vulvovaginal candidiasis and highlight the importance of accurate diagnosis through fungal cultures.
Limitations and Future Research: The study acknowledges potential bias due to reduced samples from specialist sexual health clinics during the COVID-19 pandemic and the inability to distinguish between resolved and persistent recurrent vulvovaginal candidiasis cases. Future research should investigate the reasons behind increased empirical treatment and explore alternative diagnostic and treatment strategies.
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