Resumo

Introduction: Vulvovaginal candidiasis is a common problem encountered in daily gynecological practice. Epidemiologic data suggest that, 75% of women experience at least one episode of vulvovaginal candidiasis throughout her life. The traditional diagnosis of vulvovaginal infections in Brazilian Public Health System (BPHS) is the direct microscopic examination of yeast-like cells with or without pseudohyphae, however this procedure does not provide the specie identification. This study aimed to compare the role of microscopy using stained smears and the culture method for diagnosis of vulvovaginal candidiasis, identify causative species and to examine the in vitro susceptibility to antifungal drugs in clinical isolates from vaginal secretion of women admitted at BPHS in Porto Alegre city, Southern of Brazil. Material and methods: During the study period (March 2010 to March 2011), a total of 139 vaginal secretions were analyzed. Material from the endo and ectocervice were collected with 2 sterile swabs and then done cell smears on a glass slide, which was fixed in alcohol 97%. Results and discussion: 25 patientes were positive for Candida species in vaginal secretions of 139 wich were analyzed. All isolates were susceptible to Fluconazole, but for Itraconazole 2 (8%) isolates were susceptible dose dependent (SDD). MICs for Miconazole and Nystatin were less than or equal to 2 μg/mL for C. albicans and were less than or equal to 4 μg/mL for non-Candida albicans species. Conclusion: We recommend combining microscopical examination with cultures to detect and identify Candida species in women by Brazilian Public Health System. Although all antifungals tested showed good activity against isolates of Candida from vaginal secretion, local routine monitoring of the susceptibility profiles of these organisms may be highly advisable.