Abstract
PurposeCandida pathogens are commonly found in women and can cause vulvovaginal candidiasis (VVC), whose infection rate is further increased during pregnancy. We aimed to study the Candida prevalence and strain distribution in pregnant Chinese women with a molecular beacon assay.MethodologyFrom March 2016 to February 2017, a total of 993 pregnant women attending routine antenatal visits at the Beijing Obstetrics and Gynecology Hospital were enrolled. For Candida detection and identification, a unique molecular beacon assay was presented and compared with a traditional phenotypic method. Antifungal susceptibility was tested with the following agents: 5-flucytosine, amphotericin B, fluconazole, itraconazole and voriconazole.ResultsThe prevalence of Candida was found to be 21.8 % when using the molecular method and 15.0 % when using the phenotypic method. The distribution of the Candida spp. was listed in order of decreasing prevalence: Candida albicans (79.8 %), Candida glabrata (13.5 %), Candida parapsilosis (3.7 %), Candida krusei (2.2 %) and Candida tropicalis (1.1 %). We found that 90.7 % of the Candida detection results were consistent between the molecular and the phenotypic methods. In the cases where the sequencing analyses for the Candida isolates resulted in inconsistent identification, the molecular method showed higher sensitivity than the phenotypic method (96.0 vs 64.6 %). C. albicans, C. glabrata and C. parapsilosis were essentially susceptible to all five antifungal agents tested, whereas C. tropicalis and C. krusei were susceptible to voriconazole and amphotericin B.ConclusionBy exhibiting good sensitivity and specificity, the molecular assay may offer a fast and accurate Candida screening platform for pregnant women.
Highlights
Vulvovaginal candidiasis (VVC) is the second most common cause of vaginitis, affecting 70–75 % of women of reproductive age at least once during their lifetime [1]
We found that 90.7 % of the Candida detection results were consistent between the molecular and the phenotypic methods
In the cases where the sequencing analyses for the Candida isolates resulted in inconsistent identification, the molecular method showed higher sensitivity than the phenotypic method (96.0 vs 64.6 %)
Summary
Vulvovaginal candidiasis (VVC) is the second most common cause of vaginitis, affecting 70–75 % of women of reproductive age at least once during their lifetime [1]. About 5–8 % of women suffer recurrent VVC (RVVC), experiencing four or more infection episodes per year [2]. According to a recent study involving Chinese RVVC participants, the duration of the patients’ complaints varied from 6 months to 10 years (mean duration: 22.3 months) [3]. Previous studies showed that Candida species could be isolated from at least 20 % of asymptomatic healthy women, while the infection rate increased to 30 % during pregnancy [4, 5]. Among the remaining non-albicans species, Candida glabrata is the second most common species. C. glabrata infections are more frequently associated with RVVC [1]
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