Prevalence Of Vulvovaginal Candidiasis Research Articles

Emergence of Vulvovaginal Candidiasis among Lebanese Pregnant Women: Prevalence, Risk Factors, and Species Distribution.

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.

Prevalence of vulvovaginal candidiasis in symptomatic women of reproductive age group (15-45 years) attending tertiary care institute

Prevalence of vulvovaginal candidiasis in symptomatic women of reproductive age group (15-45 years) attending tertiary care institute

Vulvovaginal candidiasis: species distribution of Candida and their antifungal susceptibility pattern

BackgroundVulvovaginal candidiasis is a global issue of concern due to its association with economic costs, sexually transmitted infections, and ascending genital tract infection. The aim of this study was to determine species distribution and antifungal susceptibility pattern of Candida species causing vulvovaginal candidiasis.MethodsA cross sectional study was conducted from November 2015 to December 2016 at the Family Guidance Association of Ethiopia. Vaginal swabs collected from study subjects that were clinically diagnosed with vulvovaginal candidiasis were cultured. Yeast identification and antifungal susceptibility testing were determined by the automated VITEK 2 compact system. The association of vulvovaginal candidiasis with possible risk factors was assessed and analyzed using SPSS version 20.ResultsThe overall prevalence of vulvovaginal candidiasis was 41.4%. The association of vulvovaginal candidiasis was statistically significant with previous genital tract infection (p = 0.004), number of life-time male sex partners (p = .037), and number of male sex partners in 12 month (p = 0.001). Of 87 Candida isolates recovered, 58.6% were C. albicans while 41.4% were non-albicans Candida species. The highest overall drug resistance rate of Candida species was observed against fluconazole (17.2%), followed by flycytosine (5.7%). All Candida isolates were 100% susceptible to voriconazole, caspofungin, and micafungin. C. albicans, was 100% susceptible to all drugs tested except fluconazole and flycytosine with a resistance rate of 2% each drug. C. krusei, was 100 and 33.3% resistant to fluconazole and flycytosine, respectively.ConclusionsHigh prevalence rate of vulvovaginal candidiasis and observation of high prevalence rate of non-albicans Candida species in the present study substantiate, the importance of conducting continuous epidemiological surveys to measure changes in species distribution from C. albicans to non-albicans Candida species in Ethiopia. Although, fluconazole still appeared to be active against all isolates of C. albicans and non-albicans Candida species high resistance rate of C. krusei against the drug may demonstrate a search for alternative antifungal drugs when treating vulvovaginal candidiasis caused by C. krusei.

PREVALENCE OF VULVOVAGINAL CANDIDIASIS IN SEXUALLY ACTIVE FEMALES WITH ANTIFUNGAL SUSCEPTIBILITY PATTERNS OF THE ISOLATES

Introduction: Vulvovaginal candidiasis (VVC) is the most common fungal infection of lower genital tract of females. It is an important cause of morbidity in young women due to its increasing incidence and is considered as an important public health problem worldwide. In recent years there has been a change in the trend of infections caused by non-albicans Candida species and anti-fungal susceptibility patterns. This study was carried out to assess the prevalence, potential risk factors and detect the antifungal susceptibilities of the isolates. Methods: A prospective study was conducted in a tertiary health centre of southern Odisha from January 2016 to December 2017and included 240 clinically diagnosed cases of VVC in the reproductive age group presenting with curdy white discharge with or without pruritus, burning, or dysuria. After getting an informed consent and brief history, vaginal swabs were collected and microscopic examination, culture and antifungal susceptibility were done. Results: Most common age group affected by VVC belonged to 26-35 years and majority of the cases were from rural areas. A total of 87 Candida species (36.3%) and, 4 Trichosporon asahii were isolated. Candida albicans was the most common isolate (52), followed by Candida glabrata. Most of the isolates were sensitive to clotrimazole (90.1%) followed by fluconazole (83.5%). Conclusion: The prevalence of VVC in our study was found to be 36.3%. Low socioeconomic status, low education, oral contraceptive pill users and Diabetes were the common predisposing factors. The most common agent causing VVC was Candidia albicans followed by Candida glabrata. Most of the yeasts isolated were sensitive to Clotrimazole followed by fluconazole. Keywords: Candida; Vulvovaginal candidiasis; Antifungal susceptibility.

Prevalence of vulvovaginal candidiasis in the women of the reproductive age, in rural India

Prevalence of vulvovaginal candidiasis in the women of the reproductive age, in rural India

Prevalence of vulvovaginal candidiasis in pregnancy at three health centers in Burkina Faso

Pregnant women are more susceptible to vaginal colonization and infection by yeast. The role of Candida colonization in the occurrence of preterm birth is well established. The knowledge of local epidemiology and identification of risk factors for preterm birth is important for the prevention and management strategies. The purpose of the study was to determine the prevalence of Candidasp. in vaginal swabs of pregnant women. Pregnant women attending routine antenatal visits in three primary health centres in Bobo-Dioulasso (Burkina Faso) were enrolled into a cross-sectional study carried out from February to April 2015. Vaginal swabs samples were taken from participants after obtaining oral consent. The swabs were inoculated into Sabouraud's glucose agar supplemented with chloramphenicol and incubated at 37°C for 24 to 48hours under aerobic conditions in order to perform fungal culture. The identification of the Candida species was done by culture on HiCrome Candida Differential Agar at 35°C for 48h for production of species-specific colors. A total of 229pregnant women were included. The prevalence of vulvovaginal candidiasis (VVC) was 22.71%, (95% CI [17.45-28.69]). Candidaalbicans accounted for 40.39% and non-Candidaalbicans species for 59.61% of the isolates, with mainly C.glabrata (32.69%), C.tropicalis (15.38%) and C.krusei (11.54%). This study revealed a high prevalence of non-C.albicans species. The syndromic management guidelines for VVC in Burkina Faso will be revised to include a specific protocol for pregnant women.

Antifungal resistance of Candida species isolated from Iraqi women infected with vulvovaginal Candidiasis

The prevalence of vulvovaginal candidiasis caused by C. albicans and other Candida species has increased dramatically over the past few decades. Vaginal cultures and susceptibility testing of these Candida species to antifungal are not routinely obtained. Therefore the aims of this study were to1. Determine the Candida species distribution among infected women with vulvovaginal candidiasis2. Prevalence of antifungal resistance among isolated Candida speciesOne handerd vaginal swabs were collected from women their age ranged from 17-40 years old with signs and symptoms of vulvovaginitis attending Medical City Hospital. All swabs were submitted to mycological study (microscopical examination, culture, full identification by performing germ tube test and Api®- candida). Finally, susceptibility testing was curried out by using modified disc diffusion method with six antifungal agents Amphotericin B, Nystatin, Fluconazole, Ketoconazole, Clotrimazole and Econazole. C. albicans was the most frequent species. (61.66%) followed by C.glabrata (33.33%) and only one isolate (1.6%) of C.tropicalis,C.krusie and C.kefyr, so the frequency of overall of other Candida species was (38.13%). However, few resistant C.albicans isolates were found against Fluconazole (21.62%), Ketoconazole (8.1%) and Econazole (5.4%).While no resistant was observed in C.albicans against Clotrimazole. Most of other Candida species were resistant to azoles specially among most isolates of C. glabrata to Ketoconazole 75%. Clotrimazole 70%, Fluconazole 65% and Econazole 20%. Our results showed elevated frequency of the overall of other Candida species particularly C. glabrata which the most prevalent species followed by C.albicans. Other Candida species specially C.glabrata were resistant to azoles in contrast to the most of C.albicans therefore culture from women with vulvovaginal candidiasis should be obtained to detect other Candida species

Epidemiologic Features of Vulvovaginal Candidiasis in Women of Childbearing Age in a Combined Military Hospital

Introduction: Vulvovaginal Candidiasis is a reproductive tract infection which remains a common cause of morbidity adversely affecting women’s physical and emotional health. Vaginal discharge in the childbearing age group is the most common complaint encountered every day both by gynaecologists and general practitioners. Among the cases of symptomatic vaginal discharge, Bacterial vaginosis is the commonest cause followed by Candidiasis and Trichomoniasis. It is characterized by curd-like vaginal discharge and itching and is associated with considerable health and economic costs.
 Objective: To detect the prevalence of Candida species in patients with complaints of vaginal discharge of reproductive age group attending at Child Welfare Centre (CWC), Gynaecology Outpatient Department (GOPD) and Medical Inspection Room (MI Room) of Combined Military Hospital (CMH) Ghatail.
 Materials and Methods: A cross-sectional descriptive study was conducted at CMH Ghatail during the period of April 2017 to October 2017. A total of 183 patients of reproductive age group with the complaints of vaginal discharge attending CWC, GOPD and MI Room of CMH Ghatail were included in this study. Two specimens of High Vaginal Swabs (HVS) were collected from each patient, one for direct microscopy and another for culture. For every patient, two wet film preparations and two Gram’s staining were done. Specimens were cultured on Blood Agar Medium and Sabourad’s Dextrose Agar Medium. Identification of Candida species was carried out by Wet film, Gram’s staining and culture examination.
 Results: According to the results of this study, the prevalence of Vulvovaginal Candidiasis (VVC) was found in 57(31.15%) of the cases. The maximum number of patients 126(66.66%) were found between 26 years to 35 years of age group. On the other hand, amongst 57 VVC positive cases, 44(77.19%)were identified as Candida albicans and 13(22.81%) were Candida non-albicans.
 Conclusion: Candida albicans is the predominant organism amongst candida species identified from VVC in this study. The high prevalence necessitates adequate screening of woman with vaginal discharge in order to give appropriate treatment and to avoid complications associated with it.
 Journal of Armed Forces Medical College Bangladesh Vol.13(1) 2017: 13-16

Prevalence, Risk Factors and Antifungal Susceptibility of Vulvovaginal Candadiasis among Saudi Females

Background: Vulvovaginal candidiasis (VVC), is the most common fungal disease in normal healthy women. Understanding of the antifungal susceptibility patterns of pathogenic fungi is essential as resistance of some vaginal yeasts isolates to antifungal agents has been reported. Objectives: to determine the prevalence of VVC, associated risk factors and evaluate antifungal susceptibility and species (spp.) distribution in Saudi patients. Methodology: High vaginal swabs were collected from all patients suffering from vaginitis. Different Candida spp. were identified by Gram stain, germ tube test, growth on CHROM agar and API 20C AUX. Antifungal susceptibility test was done by disk diffusion method. Results: VVC represented 23.5%. Out of these patients 11% had recurrent vulvovaginal candidiasis (RVVC). C. albicans represented 82% whereas non albicans spp. represented 18%. In RVVC C. albicans represented 43% and non albicans spp. represented 57%. VVC was significantly presented with pruritus and associated with pregnancy, diabetes and age group from 30 to 39 year. RVVC was significantly presented with dysuria and/ or dysparonia. All isolates were sensitive to amphotericin B, while 94% were sensitive to nystatin. Over all sensitivity to fluconazole, voriconazole, ketoconazole and miconazole was 79.5%, 86%, 96.5% and 83% respectively. Conclusion: VVC prevalence represented 23.5% whereas RVVC was 11%.C. albicans is associated with VVC, whereas non albicans spp are associated with RVVC. Diabetes, pregnancy and age group (30 – 39) are considered as potential risk factors for VVC whereas antibiotics and contraceptive pills are not. Nystatin, amphotericin B and ketoconazole have the best antifungal activity against all spp.

Comparison of enzymatic activities in different Candida species isolated from women with vulvovaginitis

Comparing the activities of secreted enzymes in different fungal species can improve our understanding of their pathogenic role. Secretion of various enzymes by Candida species has been considered for determination of their virulence in different Candida infections including vulvovaginitis. The aim of this study was to determine and compare the activity of secreted enzymes in Candidia strains isolated from women suspected to vulvovaginal candidiasis (VVC) and referred to some health centers in Khuzestan, Southwestern Iran. The vaginal secretion samples were taken by swap from 250 suspected women with symptoms of vulvovaginal candidiasis and cultured on CHROMagar Candida medium. Identification of the isolated Candida from culture positive samples performed by the color of colonies and some standard mycological procedures. Activities of phospholipase, hemolysin-α, hemolysin-β, esterase and proteinase were measured in vitro by standard laboratory protocols. The enzymatic activity index (EAI) was calculated for each enzyme in accordance to relevant protocols. Totally in eighty cases (32%), a Candida strain was isolated which found to be as 52 (65%) Candida albicans; 12 (15%) C.glabrata; 10 (12.5%) C.dubliniensis; 4 (5%) C.krusei, C.tropicalis and C.parapsilosis species (each=1; 1.3%). Among C.albicans strains, 89.1% produced all studied enzymes, while 86% of C.glabrata strains failed to produce proteinase and phospholipase. The EAIs in decreasing order were as hemolysin-β=0.2895, hemolysin-α=0.5420, esterase=0.5753, proteinase=0.7413, and phospholipase=0.7446, respectively. Activity of phospholipase, esterase and proteinase secreted by C.albicans and C.dubliniensis were significantly more than those released by C.glabrata and C.krusei, while 86% of C.glabrata strains did not show esterase activity. On the other hand, the activity rates of hemolysin α and β among all studied isolates were almost similar. In the present study, the prevalence of VVC among investigated women was higher than the previous report from Khuzestan but C.albicans has yet remained the predominant agent of VVC in this area. Given to the EAI, the virulence of C.albicans in VVC can be mediated by phospholipase, esterase and proteinases.

The Prevalence of Symptomatic Vaginal Candidiasis Among Females in Tehran, 2014

Background: Vaginitis is the most commongynecological problem and the second mostcommon infection. This condition occurs in approximately 90% of the affected females; secondary to bacterial vaginosis and vulvovaginal candidiasis. Objectives: According to the high prevalence of vulvovaginal candidiasis in Iran and because of the importance of controlling causing species, the current study aimed to evaluate the prevalence of symptomatic vaginal candidiasis among females referred to the hospitals affiliated to Shahid Beheshti University in Tehran, Iran in 2014. Patients and Methods: In this cross-sectional study, 580 females suspected of vulvovaginal candidiasis were selected by simple random sampling. In lithotomy position and after using sterile speculum without lubrication a fluid sample was obtained from the upper part of the lateral wall of the vagina and the samples were cultured on agar medium. All samples were examined by the same gynecologist. Results: The prevalence of vaginal candidiasis was 15.5% and Candida albicans was observed in 92.3% of the subjects. Conclusions: Candida albicans was the most common cause of vaginal candidiasis. Keywords: Prevalence, Vaginal Candidiasis, Candida albicans

Prevalence of vulvovaginal candidiasis among nonpregnant women attending a tertiary health care facility in Abuja, Nigeria

Prevalence of vulvovaginal candidiasis among nonpregnant women attending a tertiary health care facility in Abuja, Nigeria

Prevalence of vulvovaginal candidiasis, trichomoniasis and bacterial vaginosis among pregnant women receiving antenatal care in Southwestern Nigeria.

Vaginal infections in pregnancy are associated with considerable discomfort and adverse pregnancy outcomes including preterm delivery, low birth weight and increased infant mortality and also predisposition to HIV/AIDS. This study evaluated the prevalence and factors associated with vulvovaginal candidiasis, trichomoniasis and bacterial vaginosis among women attending antenatal clinic at a hospital in Nigeria. A semi-structured questionnaire was administered and high vaginal swab samples were obtained from consenting pregnant women. The samples were processed following standard protocols. The prevalence of vulvovaginal candidiasis was 36%, while those of trichomoniasis and bacterial vaginosis were 2% and 38%, respectively. Infections were higher in the third trimester and many women admitted to practices that increase risk of these infections. Significant association was found between recent intake of antibiotics and vaginal candidiasis, same association was also found with bacterial vaginosis. Adequate investigation and prompt treatment will reduce the morbidity and attendant effects of these prevalent infections on mother and fetus.

VULVOVAGINAL CANDIDA INFECTION PREVALENCE IN TASHKENT

Background: The information on the prevalence of vulvovaginal candidiasis does not always reflect real situation regarding this disease, since the frequency of patients’ self- treatment remains high, as evidenced by the results of the studies based on anonymous surveys. The prevalence of this disease is growing steadily both in Uzbekistan and elsewhere in the world. Accumulated problems have provided grounds to conduct the research on the prevalence of Candida vulvovaginitis in the juvenile age population of Tashkent city. Method: The study included examining of 2107 adolescent aged girls of high schools, lyceums and colleges of Tashkent city. Results: Thus, in the studied region the prevalence of Candida vulvovaginitis in adolescent population is high, which in turn requires to take steps to further improve treatment and prevention.

Epidemiologic Features of Vulvovaginal Candidiasis among Reproductive-Age Women in India

Background. Vulvovaginal candidiasis is characterized by curd-like vaginal discharge and itching, and is associated with considerable health and economic costs. Materials and Methods. We examined the incidence, prevalence, and risk factors for vulvovaginal candidiasis among a cohort of 898 women in south India. Participants completed three study visits over six months, comprised of a structured interview and a pelvic examination. Results. The positive predictive values for diagnosis of vulvovaginal candidiasis using individual signs or symptoms were low (<19%). We did not find strong evidence for associations between sociodemographic characteristics and the prevalence of vulvovaginal candidiasis. Women clinically diagnosed with bacterial vaginosis had a higher prevalence of vulvovaginal candidiasis (Prevalence 12%, 95% CI 8.2, 15.8) compared to women assessed to be negative for bacterial vaginosis (Prevalence 6.5%, 95% 5.3, 7.6); however, differences in the prevalence of vulvovaginal candidiasis were not observed by the presence or absence of laboratory-confirmed bacterial vaginosis. Conclusions. For correct diagnosis of vulvovaginal candidiasis, laboratory confirmation of infection with Candida is necessary as well as assessment of whether the discharge has been caused by bacterial vaginosis. Studies are needed of women infected with Candida yeast species to determine the risk factors for yeast's overgrowth.

Prevalence of vulvovaginal candidiasis and susceptibility to fluconazole in women

Objective: The purpose of this study was to determine the prevalence of vaginal colonization by Candida with the use of a rapid detection method, to examine the determinants of vaginal candidiasis, and to evaluate susceptibility for fluconazole. Study Design: Vaginal swabs were collected from unselected women at the outpatient clinic of the Department of Obstetrics and Gynecology. A differentiation was made between patients with a positive and a negative potassium hydroxide examination. Results: Six hundred twelve women were recruited, of whom 39 women (6.3%) had clinical candidiasis. The overall rate of yeast colonization was 20.1%. Candida albicans was isolated most frequently(68.3%), followed by C glabrata (16.3%) and C parapsilosis (8.9%). Clinical candidiasis was related positively with the state of estrogen impregnation. In vitro susceptibility testing by the National Committee for Clinical Laboratory Standards method for fluconazole revealed that 21.1% of the isolates were resistant. Conclusion: More than 20% of the unselected women were colonized with Candida species. Hyperestrogenemia was associated with an increased vulvovaginal colonization by Candida. Surprisingly, 21% of the isolates was resistant to fluconazole, according to the National Committee for Clinical Laboratory Standards method. (Am J Obstet Gynecol 2002;187:569-74.)

Distinct Protective Host Defenses against oral and vaginal Candidiasis

Oral and vaginal candidiasis are the two most common forms of opportunistic fungal infections. However, the prevalence of each can be quite variable depending on the immune status of the host. While vulvovaginal candidiasis (VVC) is equally common in immunocompetent and immunocompromised women, oropharyngeal candidiasis (OPC) is infrequent except under immunocompromised states. Candida albicans, the causative agent in the majority of cases, is a commensal of the gastrointestinal and lower female reproductive tracts. Thus, most healthy individuals have protective Candida-specific immunity that normally prevents infection. Studies from animal models, women with recurrent VVC (RVVC) and HIV-infected individuals, however, suggest that distinct protective host defense mechanisms may function against OPC and VVC. While local and systemic cell-mediated immunity (CMI) appear important for protection against OPC, there is little evidence to indicate that either local or systemic CMI plays a role against VVC. Innate resistance is also considered distinct at both sites with considerably less activity at the vaginal mucosa, including the newfound anti-Candida activity by epithelial cells. Finally, the protective role of humoral immunity has been and remains uncertain. Taken together, the differential prevalence of VVC and OPC is directly proportional to the levels of demonstrable innate and adaptive host defenses at each site.

Managing Patients with Vulvovaginal Candidiasis

Epidemiologic studies have demonstrated a continuing increase in the prevalence of vulvovaginal candidiasis. Although in the past most of these infections were caused by Candida albicans, an increasing percentage are caused by non-albicans Candida species that are less sensitive to the most frequently used antifungal agents. An accurate diagnosis of these infections and the subsequent choice of the most appropriate therapy can only be made after a thorough evaluation of the patient. Successful treatment of vulvovaginal candidiasis is dependent on compliance with therapy; thus, the treatment regimen chosen should fit the patient's daily lifestyle. Newer single-dose regimens offer the option of completing therapy with a single treatment for most patients with uncomplicated vaginal candidiasis. Use of topical agents avoids the potential systemic adverse effects and drug interactions that have been noted with oral antifungals. Patient education and support can also enhance satisfaction with the treatment plan and promote compliance.