Vulvovaginal candidiasis (VVC) is one of the most common superficial fungal infections affecting women. A particularly challenging issue is the treatment of recurrent vulvovaginal candidiasis (RVVC)—defined as ≥4 episodes of VVC within 12 months—which affects 5–8% of women with VVC. The development of VVC is influenced by many risk factors related to the host organism and behaviour, including disturbances in the vaginal microflora, hormonal fluctuations, diabetes, hygiene and sexual behaviour. Although C. albicans remains the primary species causing this infection, infections caused by other species, such as Nakaseomyces glabratus and Pichia kudriavzevii, are becoming increasingly common, partly due to the widespread use of azole antifungal drugs and growing drug resistance. Therefore, this publication focuses on a review of the newest literature concerning the epidemiology, diagnosis, current approaches to antifungal susceptibility testing and treatment according to global guidelines. According to the literature, precise species identification and drug susceptibility testing are crucial to avoid therapeutic errors and drug resistance. Moreover, new antifungal drugs such as tetrazoles (oteseconazole) and triterpenoids (ibrexafungerp) are entering clinical practice, offering high efficacy against resistant strains. Probiotics used as adjuvant therapy help restore the homeostasis of the vaginal microbiome; however, due to inconsistent evidence, they are currently not included in treatment recommendations.

(1) Background: Meyerozyma guilliermondii is a yeast species widely distributed in the natural environment and one of the rare emerging pathogens capable of causing difficult to treat, severe infections. The species’ susceptibility profile is not fully defined; however, the species could be more prone to develop resistance than other Candida species. The objective of this research was to determine the susceptibility of a local collection of Meyerozyma guilliermondii clinical isolates to classical antifungal drugs as well as a new one—manogepix. (2) Methods: The study included 20 clinical isolates identified using the MALDI–TOF method followed with sequencing of ITS1-2 region of DNA. Overall, the susceptibility to 12 antifungal drugs was tested. Nine drugs (amphotericin B, flucytosine, fluconazole, itraconazole, posaconazole, voriconazole, anidulafungin, caspofungin, and micafungin) were assessed using the MICRONAUT–AT test. The susceptibility to the new drug, manogepix, as well as isavuconazole, clotrimazole and anidulafungin, was determined using the microdilution method recommended by EUCAST. Additionally, anidulafungin and voriconazole MIC was also examined with commercial gradient tests. (3) Results: Overall, the isolates showed low MIC values for amphotericin B (0.125 to 1 mg/L) and for flucytosine (≤0.06 to 32 mg/L), with the exception of one isolate with a high MIC value. The MIC ranges for azoles were 2–64 mg/L (fluconazole), 0.008–0.5 mg/L (voriconazole), ≤0.03–≥4 mg/L (itraconazole) and 0.008–0.5 mg/L (posaconazole). One isolate showed non-WT phenotype to all tested azoles. For anidulafungin, the MIC values ranged from ≤0.06 to 0.25 mg/L; however, in the reference method, higher values were observed, but they did not exceed 2 mg/L (ECOFF value). For manogepix, the MIC values ranged from 0.002 to 0.125 mg/L. Finally, the comparison of the obtained and published susceptibility data was conducted. (4) Conclusions: The data obtained in this study are consistent with reports by other authors and indicate that resistance to azoles or 5-fluorocytosine among clinical isolates of Meyerozyma guilliermondii should be considered. The low MIC values of manogepix suggest the potentially good efficacy of this drug against Meyerozyma guilliermondii species.