Start with accurate identification of the Candida species for appropriate vulvovaginal candidiasis treatment.1,2


Candida species C. glabrata and C. krusei are important causes of vulvovaginal candidiasis (VVC) and are often resistant to traditional treatment.2

VVC is usually caused by C. albicans but can also be caused by other Candida species, which are referred to as non-albicans Candida.1

The issue is that non-albicans Candida such as C. glabrata and C. krusei are known to be less responsive or even resistant to some antifungal agents.1,2 This means that a patient infected with C. glabrata or C. krusei is at higher risk of treatment failure, continued symptoms and VVC recurrence.1,2 In fact, C. glabrata and other non-albicans Candida species are more commonly found in recurrent VVC – which is defined as four or more episodes of symptomatic VVC within 1 year – as compared to sporadic VVC.1,2

 

 

50% of C. glabrata causing a VVC infection have decreased sensitivity to fluconazole.2

 

C. krusei is intrinsically resistant to fluconazole.2

 

C. glabrata and other non-albicans Candida species are observed in 10 to 20% of women with recurrent VVC, which is defined as four or more episodes of symptomatic VVC within 1 year.1,2

 

Accurate identification of Candida species and treatment may help reduce vulvovaginal candidiasis recurrence due to antifungal resistance.2

Non-albicans candidiasis is considered a complicated form of VVC and requires a different treatment regimen to C. albicans infection.1

For uncomplicated VVC and recurrent VVC caused by C. albicans, treatments may involve the use of fluconazole – either as a single dose or over several weeks of treatment. On the other hand, non-albicans Candida species such as C. glabrata and C. krusei have a low susceptibility or are resistant to fluconazole and should be treated with a different agent.1

Using fluconazole for VVC caused by C. glabrata and C. krusei may increase the risk of treatment failure, continued symptoms, VVC recurrence and potentially severe complications.1,2

 

Recurrent VVC caused by C. albicans

Recurrent VVC caused by C. albicans requires an initial fluconazole therapy followed by a fluconazole maintenance therapy.1

Severe VVC

One of the recommended treatments for severe VVC is fluconazole in 2 sequential doses.1

Non-albicans Candida

Infection with non-albicans Candida such as C. glabrata and C. krusei usually involves a longer duration of therapy with a nonfluconazole azole regimen.1

 

 

When you know which Candida strain is causing the infection – especially in patients with recurrent VVC – you can prescribe the appropriate treatment course from the start to help avoid continued or recurring VVC symptoms and prevent potentially severe complications.1-3 

 

Complications of
vaginitis and vaginosis

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Differentiating between species of Candida can be achieved in a few hours with a molecular test.

Although C. glabrata and C. krusei are important causes of VVC, they are clinically indistinguishable from C. albicans using microscopy.2
On the other hand, Candida culture is possible but may delay the initiation of an appropriate treatment.4


A molecular test such as BD MAX™ Vaginal Panel can identify and differentiate Candida species in just a few hours.5

BD MAX™ Vaginal Panel is the only FDA-cleared molecular assay to differentiate between C. glabrata and C. krusei, two Candida species that may not respond to traditional therapeutics.2,5-7

 

Compare FDA-cleared
vaginitis tests

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FDA, food and drug administration; VVC, vulvovaginal candidiasis.

1. Workowski KA et al. MMWR Recomm Rep. 2021;70(4):1–187.
2. Thompson A et al. Eur J Clin Microbiol Infect Dis. 2020;39(1):39–44.
3. Hildebrand JP, Kansagor AT. Vaginitis. [Updated 2022 Feb 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470302/
4. Gaydos CA et al. Obstet Gynecol. 2017;130(1):181–9.
5. BD MAX™ Vaginal Panel Package Insert (P0258).
6. Hologic Aptima® CV/TV Assay Package Insert.
7. Cepheid Xpert® Xpress MVP Instructions for Use.