Determinants of different Candida species infections of the genital tract in women

Abstract

Objective: We have analyzed the differences in the epidemiological characteristics of women with different Candida low female genital tract infection. Study design: Eligible for the study were 4228 women aged 18–70 years with symptomatic low gynecological tract infection and clinical findings suggestive for Candida infection consecutively attending during the study period first level outpatients gynecological services in Italy. CHROMagar Candida method was used to identify albicans and non- albicans species and among non- albicans ones Candida glabrata, tropicalis and krusei. Results: Out of the 4228 women who entered the study, Candida infection was confirmed by CHROMagar test in 3351 cases (79.3%): Candida albicans was identified in 1431 cases (43%) and non- albicans in 1920. Among the 1920 women with non- albicans infection, Candida glabrata was identified in 1207 women, Candida krusei in 290, Candida tropicalis in 404 (in 19 cases other species or non-specified species were involved). Candida albicans infection was more frequently reported than non- albicans ones in diabetic women (Odds Ratio, OR=1.7, 95%, Confidence Interval, CI 1.1–2.7). Current oral contraceptive users tended more frequently to be infected with Candida albicans than non- albicans, however the estimated OR was only slightly above unity and of borderline statistical significance (OR 1.3, 9.5%, CI 1.1–1.5). Women reporting previous treatment with topic antimicotic reported more frequently non- albicans infection, than Candida albicans ones. However the association was limited and of borderline statistical significance (OR albicans vs. non albicans 0.7, 95% CI 0.5–1.0). Albicans infection was more frequently identified in women whose partner reported symptomatology for Candida infection (OR 1.7, 95% C.I. 1.4–2.0). Conclusions: This study shows that in this Italian population with symptomatic Candida infection of low female genital tract, there are some differences in the epidemiological characteristics of women with albicans and non- albicans infection.