Emergence of Resistance to Amphotericin B and Triazoles in Candida glabrata Vaginal Isolates in a Case of Recurrent Vaginitis

Abstract

Emergence of resistance to triazoles and amphotericin B in Candida glabrata vaginal isolates is documented by Etest. During the 18-month follow-up of a case of vaginitis, 14 consecutive isolates of C. glabrata were examined. The isolates exhibited development of in vitro resistance beginning with itraconazole (>32 μg/ml), followed by fluconazole (>256 μg/ml), amphotericin B (>32 μg/ml), and voriconazole (>32 μg/ml). The DNA sequence analyses and finger printing of the isolates strongly suggest that our patient remained colonized with a single strain. The report underscores the propensity of C. glabrata to acquire resistance during antifungal therapy and the importance of susceptibility testing in the management of infections caused by this species.