Abstract
Objective Candida species colonize the vagina in at least 20% of women, with rates rising to 30% during pregnancy. This study aimed at determining the prevalence and risk factors of vulvovaginal candidiasis (VVC) in pregnant women at 35-37 weeks of gestation. It also aims at finding possible correlations between VVC and vaginal colonization by other agents, such as Group B Streptococcus (GBS) and bacterial vaginosis. Methodology Over a one-year period, high vaginal swabs were collected from pregnant women during their regular antenatal checkup in different polyclinics in Beirut and South Lebanon. Swabs were examined microscopically, cultured on Sabouraud Dextrose Agar, and Candida isolates were identified using Chromatic Candida medium and Germ Tube Test. Results VVC was detected in 44.8% of samples, with C. glabrata (44.4%) and C. albicans (43.4%) being the most isolated species. Approximately, half of pregnant women (57.7%) were coinfected with Candida and bacterial vaginosis, while 26% of them carried simultaneously Candida spp. and GBS. No significant correlation was found between the occurrence of VVC and demographic, clinical, medical, and reproductive health characteristics of pregnant women. In contrast, participants with previous miscarriages and those being hospitalized during the past 12 months were more susceptible to develop vaginal C. krusei infection in comparison to other Candida species (p=0.0316 and p=0.0042, respectively). Conclusion The prevalence of VVC in pregnant women is an increasing trend in our community. Therefore, routine medical examination and regular screening for candidiasis in the antenatal care program is highly recommended to manage the disease and its complications.
Highlights
Vulvovaginal candidiasis (VVC) is an opportunistic mucosal infection and the second most common vaginal infection affecting women of reproductive age [1]
The prevalence of C. albicans infections was 43.4%, while nonalbicans Candida strains counted for 56.6% of vulvovaginal candidiasis (VVC), the main identified species being C. glabrata (44.5%) followed by C. krusei observed only in 12.1% of vaginal candidiasis
In 2% of cases, women were infected with C. albicans and C. glabrata concurrently
Summary
Vulvovaginal candidiasis (VVC) is an opportunistic mucosal infection and the second most common vaginal infection affecting women of reproductive age [1]. It affects more than 75% of women at least once in their lifetime, with approximately 50% of them suffering a single recurrence [1, 2]. Different factors related to physiologic changes, such as decreased cellular immunity, elevated hormone levels, reduced vaginal pH, and increased vaginal glycogen concentration, have been associated with a higher risk of VVC during pregnancy [6, 9, 10]. When balance between Candida, normal bacterial flora, and immune defense mechanisms is disturbed, colonization is replaced by infection
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