From Identification to Resistance: Contemporary Insights into Candida Species Causing Vaginitis

Vulvovaginal candidiasis (VVC) is among the most frequent reasons why vaginitis occurs in women and represents a significant clinical and public health concern worldwide. Although Candida albicans remains the predominant etiological agent, infections due to non-albicans species of Candida (NAC) like C. glabrata, C. tropicalis, C. krusei, and C. parapsilosis are increasingly reported, particularly in recurrent and complicated cases. The pathogenesis of VVC is multifactorial and influenced by host immune status, hormonal factors, disruption of the vaginal microbiota, and metabolic conditions such as diabetes mellitus, antibiotic use, and pregnancy. Emerging antifungal resistance, especially to azole drugs, poses a major challenge in the oversight of VVC and underscores the importance of accurate identification of species and susceptibility to antifungal testing. Chromogenic media and standardized in vitro susceptibility methods have improved rapid diagnosis and targeted therapy. This review highlights the epidemiology, risk factors, pathogenic mechanisms, virulence attributes, diagnostic approaches, and therapeutic challenges associated with VVC, with an emphasis on the growing clinical relevance of NAC species and antifungal resistance. Continued surveillance, improved diagnostics, and development of novel antifungal strategies are essential to optimize patient outcomes and reduce disease burden.