Phenotypic profile, molecular differentiation, production of enzymes and antifungal susceptibility of yeasts isolated from samples in three sample groups: asymptomatic women with primary and recurrent vulvovaginal candidiasis.

O presente estudo foi realizado com 258 mulheres, com e sem sintomas de candidíase vulvovaginal, atendidas no Centro de Saúde Geraldo Paula Souza, da Faculdade de Saúde Pública da USP. Leveduras foram isoladas em 162 mulheres, sendo que 34% foram de mulheres assintomáticas, 34% com sintomas de candidíase vulvovaginal primária (CVV) e 32% com candidíase vulvovaginal recorrente (CVVR). As espécies mais isoladas foram C . albicans, C. parapsilosis, C. glabrata e C. tropicalis. Espécies como C. metapsilosis e C. haemulonii também foram encontradas. A produção de proteinase foi vista em 88% das amostras e de fosfolipase foi de 39%. A sensibilidade in vitro aos antifúngicos foi realizada pelo Etest e, nos isolados resistentes a anfotericina B, fluconazol e itraconazol foram realizados ensaios de microdiluição (CLSIM27S3) e EUCAST EDef7.1, que confirmaram a diminuição da sensibilidade ao itraconazol em isolados de C. parapsilosis (1); C. guilliermondii (1), C. glabrata (3) e Trichosporon spp (1). A diminuição da sensibilidade ao fluconazol foi observada em isolados de C. parapsilosis (1), C. glabrata (3), C. krusei e Rhodotorula spp (1). As leveduras do grupo das CVVRs foram as que apresentaram menor sensibilidade. Em 61 isolados de várias espécies foi realizada a cariotipagem em campo pulsado (PFGE) e não foram observadas similaridade entre elas. Os dados obtidos reforçam a importância da realização de exames laboratoriais que permitam identificar as espécies presentes no conteúdo vaginal, de modo a nortear a escolha terapêutica.This study was conducted with 258 women, with and without symptoms of vulvovaginal candidiasis, seen at the Health Center \"Geraldo Paula Souza\", School of Public Health of USP. Yeasts were isolated in 162 women, 34% of women were asymptomatic, 34% with primary symptoms of vulvovaginal candidiasis (VVC) and 32% with recurrent vulvovaginal candidiasis (CVVR). The species were more isolated C. albicans, C. parapsilosis, C. glabrata and C. tropicalis. Species such as C. metapsilosis and C. haemulonii were also found. The production of proteinase was seen in 88% of the samples and phospholipase was 39%. Sensitivity \"in vitro\" Antifungal was by the \"Etest\" and in isolates resistant to amphotericin B, fluconazole and itraconazole microdilution tests were performed (CLSIM27S3) and EUCAST EDef7.1, which confirmed the decreased sensitivity to itraconazole in isolates C. parapsilosis (1), C. guilliermondii (1), C. glabrata (3) and Trichosporon spp (1). The decreased sensitivity to fluconazole was observed in isolates of C. parapsilosis (1), C. glabrata (3), C. krusei and Rhodotorula spp (1). Yeasts of the group CVVRs were those who had lowest sensitivity. In 61 isolated from various species karyotyping was performed pulsed field (PFGE) and there were no similarity between them. The data emphasize the importance of laboratory tests to identify the species present in the vaginal content in order to guide the therapeutic choice