Antifungal resistance of candida glabrata in recurrent vulvovaginal infections

Recurrent vulvovaginal candidiasis (RVVC) represents a significant clinical challenge in gynecological practice, characterized by frequent episodes of infection that negatively impact patients' quality of life. Although Candida albicans is the most common pathogen, there is an increasing prevalence of non-albicans species, notably Candida glabrata. This yeast is recognized for its intrinsic reduced susceptibility to azole agents, frequently used as first-line therapy, which poses difficulties in clinical management and favors symptom persistence. This study aims to conduct a systematic literature review on the antifungal resistance mechanisms of Candida glabrata in cases of RVVC and emerging therapeutic strategies for its control. The methodology was based on a bibliographic search in the SciELO and LILACS databases, selecting studies published in the last decade on susceptibility profiles and clinical outcomes. The results show that Candida glabrata presents effective adaptive mechanisms, such as overexpression of efflux pumps and mutations in azole molecular targets, requiring the use of alternative therapies such as boric acid or new topical agents. It is concluded that accurate etiological diagnosis, through culture and susceptibility testing, is essential for managing recurrent infections, and it is recommended to discontinue the empirical and prolonged use of azole antifungals in cases of documented resistance.(AU)