Prevalence of Candida albicans and non-albicans isolates from vaginal secretions: comparative evaluation of colonization, vaginal candidiasis and recurrent vaginal candidiasis in diabetic and non-diabetic women.

Luciene Setsuko Akimoto Gunther,Helen Priscila Rodrigues Martins,Fabrícia Gimenes,Marcia Edilaine Lopes Consolaro,André Luelsdorf Pimenta De Abreu,Terezinha Inez Estivalet Svidzinski

doi:10.1590/1516-3180.2014.1322640

Luciene Setsuko Akimoto Gunther, Helen Priscila Rodrigues Martins + Show 4 more

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https://doi.org/10.1590/1516-3180.2014.1322640

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Abstract

Vulvovaginal candidiasis (VVC) is caused by abnormal growth of yeast-like fungi on the female genital tract mucosa. Patients with diabetes mellitus (DM) are more susceptible to fungal infections, including those caused by species of Candida. The present study investigated the frequency of total isolation of vaginal Candida spp., and its different clinical profiles - colonization, VVC and recurrent VVC (RVVC) - in women with DM type 2, compared with non-diabetic women. The cure rate using fluconazole treatment was also evaluated. Cross-sectional study conducted in the public healthcare system of Maringá, Paraná, Brazil. The study involved 717 women aged 17-74 years, of whom 48 (6.7%) had DM type 2 (mean age: 53.7 years), regardless of signs and symptoms of VVC. The yeasts were isolated and identified using classical phenotypic methods. In the non-diabetic group (controls), total vaginal yeast isolation occurred in 79 (11.8%) women, and in the diabetic group in 9 (18.8%) (P = 0.000). The diabetic group showed more symptomatic (VVC + RVVC = 66.66%) than colonized (33.33%) women, and showed significantly more colonization, VVC and RVVC than seen among the controls. The mean cure rate using fluconazole was 75.0% in the diabetic group and 86.7% in the control group (P = 0.51). We found that DM type 2 in Brazilian women was associated with yeast colonization, VVC and RVVC, and similar isolation rates for C. albicans and non-albicans species. Good cure rates were obtained using fluconazole in both groups.

Highlights

Vulvovaginal candidiasis (VVC) is classified by the World Health Organization (WHO) as a pathological condition that is frequently sexually transmitted (STD).[1]
Subjects were identified as affected by diabetes mellitus (DM) type 2 according to the American Diabetes Association (ADA) definition, if their fasting serum glucose was 7 mmol/l (126 mg/dl) or more, as reported in the patients’ medical records
In the control group, total vaginal yeast isolation occurred in 79 (11.8%) women, distributed as C. albicans (n = 43; 54.4%) and non-albicans species (n = 36; 45.6%)

Summary

Introduction

Vulvovaginal candidiasis (VVC) is classified by the World Health Organization (WHO) as a pathological condition that is frequently sexually transmitted (STD).[1] Because it affects millions of women annually, thereby causing great discomfort, interfering with sexual and affective relations and impairing work performance, VVC has been considered to be an important worldwide public health problem.[2]. VVC is caused by abnormal growth of yeast-like fungi on the mucosa of the female genital tract. It is clinically characterized by occurrences of intense vulvar itching, leucorrhea, dyspareunia, dysuria, edema and vulvovaginal erythema.[2,3] Vaginal yeasts become pathogenic when the colonization site on the host is favorable to their development. Several factors may increase this risk, such as previous colonization by the yeast, immunosuppressive diseases, diabetes mellitus (DM) and other factors.[4,5]

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