- Academic Editors
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Background: Candida albicans (C. albicans) and
Candida glabrata (C. glabrata) are mainly associated
with vulvovaginal candidiasis (VVC). Management of VVC caused by C.
glabrata is particularly challenging due to its inherent reduced susceptibility
to fluconazole. In this prospective laboratory-based cohort study, we
investigated the effect of pH on in vitro susceptibility of
Candida spp. isolates to fluconazole and flucytosine. Methods:
Vaginal isolates of C. glabrata, C. albicans, Candida
tropicalis (C. tropicalis) and Candida parapsilosis (C.
parapsilosis) were tested for susceptibility to fluconazole and flucytosine by
Epsilometer test (ETEST) strips on Roswell Park Memorial Institute (RPMI) 1640 medium at pH 7.0 and
pH 4.5. Minimum inhibitory concentrations (MICs) were read after 24 h at 35 °C.
Results were interpreted according to the European Committee on Antimicrobial
Susceptibility testing (EUCAST) guidelines. Results: Mean fluconazole
MICs (µg/mL) at pH 4.5 were significantly higher than those at pH
7.0 for C. glabrata (82.55