PREVALENCE OF AND RISK-FACTORS FOR FUNGAL VAGINITIS CAUSED BY NON-ALBICANS SPECIES

OBJECTIVE: Our purpose was to evaluate the prevalence of symptomatic y east vaginitis caused by non-albicans species among patients attending a vaginitis clinic over an 8-year period. STUDY DESIGN: A retrospecti ve study of 1263 patients with symptomatic yeast vaginitis confirmed b y culture techniques was performed. RESULTS: The prevalence of symptom atic fungal vaginitis caused by non-albicans species increased from 9. 9% (10/101) in 1988 to 17.2% (36/209) in 1995 (chi(2) for trend = 9.33 , p = 0.002). Non-albicans species were found more frequently in known human immunodeficiency virus-seropositive patients (23/102 vs 143/116 1, odds ratio 2.07, 95% confidence interval 1.2 to 3.46) than in seron egative subjects or subjects of unknown status for the virus. Recurren t vaginal candidiasis was an additional risk factor for vaginitis caus ed by non-albicans species (odds ratio 2.47, 95% confidence interval 1 .72 to 3.52). The increase in non-albicans isolates during the study p eriod was confirmed in stratified analysis and in the subgroup of self -referred patients with no history of either human immunodeficiency vi rus infection or recurrent vaginal candidiasis. CONCLUSION: The preval ence of fungal vaginitis caused by non-albicans species has increased sharply in the setting of a vaginitis clinic. The characteristics of r isk factors suggest that fungal cultures should be done routinely in h uman immunodeficiency virus-seropositive subjects with suspected vagin al candidiasis and in patients with recurrent vaginal infection.