{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:20:01Z","timestamp":1785410401977,"version":"3.56.0"},"reference-count":81,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T00:00:00Z","timestamp":1778889600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Eidikos Logariasmos Kondilion kai Ereunas, University of Patras"},{"id":[{"id":"https:\/\/ror.org\/017wvtq80","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Special Account for Research Grants University of Athens"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Candida species, particularly Candida albicans (C. albicans), are the leading cause of vulvovaginal candidosis (VVC) among women of reproductive age. In recent years, the epidemiology of VVC has shifted toward non-albicans Candida (NAC) species, accompanied by increasing antifungal resistance. This retrospective study evaluated the epidemiological profile of VVC and antifungal susceptibility patterns in Greece between 2020 and 2024 at a tertiary maternity and gynecological hospital. Species identification was performed using the VITEK\u00ae 2 system, and antifungal susceptibility followed EUCAST guidelines. A total of 526 vaginal swab samples were analyzed, comprising C. albicans (57.9%) and NAC species (42.1%). The median age was 36.3 years (range: 18\u201392). Among NAC isolates, Nakaseomyces glabratus (26.4%) predominated, followed by Pichia kudriavzevii (7.6%), Candida parapsilosis (5.1%), and Candida tropicalis (3.0%). Resistance rates among C. albicans isolates increased from 9.3% in 2020 to 22.3% (fluconazole) and 20.9% (itraconazole) in 2024. Voriconazole resistance was not detected until 2023 and 2024, when rates rose to 3.2% and 15.2%. Fluconazole resistance was observed in C. parapsilosis (3.5%) and C. tropicalis (12.5%). Echinocandin resistance remained low overall, except for N. glabratus, which demonstrated a 13.8% resistance rate to caspofungin. These findings highlight the need for surveillance, improved diagnostics and antifungal stewardship.<\/jats:p>","DOI":"10.3390\/pathogens15050538","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T16:07:26Z","timestamp":1779206846000},"page":"538","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Evolving Epidemiology and Emerging Antifungal Resistance in Vulvovaginal Candidosis: Evidence from a Five-Year Survey"],"prefix":"10.3390","volume":"15","author":[{"given":"Aristotelis","family":"Tsiakalos","sequence":"first","affiliation":[{"name":"\u201cHygeia\u201d General Hospital, 6 Erythrou Stavrou Street, 15123 Marousi, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Despoina","family":"Papageorgiou","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University General Hospital of Patras, 26504 Rio, Greece"},{"name":"Department of Medicine, University of Patras, 26504 Rio, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1951-8489","authenticated-orcid":false,"given":"Vassiliki C.","family":"Pitiriga","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Medical School of Athens, National and Kapodistrian University of Athens, 75 Mikras Asias Str., 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Vogiatzi","sequence":"additional","affiliation":[{"name":"\u201cLeto\u201d General, Maternity & Gynecology Clinic, Mouson 7-13 Street, 11524 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panayotis D.","family":"Ziakas","sequence":"additional","affiliation":[{"name":"Department of Medicine, Brown University, Providence, RI 02912, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Routsias","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Medical School of Athens, National and Kapodistrian University of Athens, 75 Mikras Asias Str., 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelia","family":"Dimitroulia","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Medical School of Athens, National and Kapodistrian University of Athens, 75 Mikras Asias Str., 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4289-9494","authenticated-orcid":false,"given":"Karolina","family":"Akinosoglou","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University General Hospital of Patras, 26504 Rio, Greece"},{"name":"Department of Medicine, University of Patras, 26504 Rio, Greece"},{"name":"Division of Infectious Diseases, University General Hospital of Patras, 26504 Rio, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1961","DOI":"10.1016\/S0140-6736(07)60917-9","article-title":"Vulvovaginal candidosis","volume":"369","author":"Sobel","year":"2007","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e339","DOI":"10.1016\/S1473-3099(18)30103-8","article-title":"Global burden of recurrent vulvovaginal candidiasis: A systematic review","volume":"18","author":"Denning","year":"2018","journal-title":"Lancet Infect. 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