Vulvovaginal Candidiasis Research Articles

Effect of the Pulsatilla decoction n-butanol extract on vulvovaginal candidiasis caused by Candida glabrata and on its virulence factors

Vulvovaginal candidiasis (VVC) caused by Candida glabrata (C. glabrata) is more persistent and resistant to treatment than when caused by Candida albicans (C. albicans) and has been on the rise in recent years. The n-butanol extract of Pulsatilla Decoction (BEPD) has been shown to be effective in treating VVC caused by C. glabrata, but the underlying mechanism of action remains unclear. In this study, the experimenter conducted in vitro and in vivo experiments to explore the effects of BEPD on the virulence factors of C. glabrata, as well as its efficacy, with a focus on possible immunological mechanism in VVC caused by C. glabrata. The contents of Anemoside B4, Epiberberine, Berberine, Aesculin, Aesculetin, Phellodendrine and Jatrorrhizine in BEPD, detected by high-performance liquid chromatography, were 31,736.64, 13,529.66, 105,143.72, 19,406.20, 4952.67, 10,317.03, 2489.93 μg/g, respectively. In vitro experiments indicated that BEPD moderately inhibited the growth of C. glabrata, its adhesion, and biofilm formation, and affected the expression of efflux transporters in the biofilm state. In vivo experiments demonstrated that BEPD significantly reduced vaginal inflammatory manifestation and the release of proinflammatory cytokines and LDH in mice with VVC caused by C. glabrata. Moreover, it inhibited the Phosphorylation of EGFR, ERK, P38, P65, and C-Fos proteins. The results suggested that although BEPD moderately inhibits the growth and virulence factors of C. glabrata in vitro, it can significantly reduce vaginal inflammation by down-regulating the EGFR/MAPK signaling pathway in mice with VVC infected by C. glabrata.

Impact of Vaginal Douching on Women's Health; Benefits and Potential Health Risk

For decades, vaginal douching, the practice involving the cleansing of the vaginal canal with water or mixture of fluids has ignited controversy, sparking debates about its potential benefits and detrimental impacts on women's health. The risks of vaginal douching far outweigh any unproven benefits as this procedure provides a pressurized fluid vehicle for pathogen transport, helping lower genital tract infections ascend above the cervix, into the uterus, fallopian tubes and abdominal cavity, disrupting natural equilibrium of the vagina and leading to a wide range of adverse outcomes including pelvic inflammatory disease, bacterial vaginosis, cervical cancer, poor pregnancy outcomes, sexually transmitted infections, recurrent vulvovaginal candidiasis, and infertility. Additionally, douching may interfere with the body's natural defense mechanisms against pathogens, making it easier for infections to take hold. Furthermore, some douching products contain harsh chemicals that can irritate the vaginal tissue and cause discomfort or pain and therefore, a strict reevaluation of the practice's necessity for women's health is recommended as the best way to support vaginal health is to ensure good overall hygiene and let the body's natural processes do their job. Keywords: Douching, Women, Benefits and Health risk

Vaginal prevention of Candida albicans: synergistic effect of lactobacilli and mannan oligosaccharides (MOS)

Vulvovaginal candidiasis (VVC) affects approximately 30–50% of women at least once during their lifetime, causing uncomfortable symptoms and limitations in their daily quality of life. Antifungal therapy is not very effective, does not prevent recurrencies and usually causes side effects. Therefore, alternative therapies are urgently needed. The goal of this work was to investigate the potential benefits of using mannan oligosaccharides (MOS) extracts together with a Lactobacillus sp. pool, composed by the most significant species present in the vaginal environment, to prevent infections by Candida albicans. Microbial growth of isolated strains of the main vaginal lactobacilli and Candida strains was assessed in the presence of MOS, to screen their impact upon growth. A pool of the lactobacilli was then tested against C. albicans in competition and prophylaxis studies; bacterial and yeast cell numbers were quantified in specific time points, and the above-mentioned studies were assessed in simulated vaginal fluid (SVF). Finally, adhesion to vaginal epithelial cells (HeLa) was also evaluated, once again resorting to simultaneous exposure (competition) or prophylaxis assays, aiming to measure the effect of MOS presence in pathogen adherence. Results demonstrated that MOS extracts have potential to prevent vaginal candidiasis in synergy with vaginal lactobacilli, with improved results than those obtained when using lactobacilli alone.Key pointsPotential benefits of MOS extracts with vaginal lactobacilli to prevent C. albicans infections.MOS impacts on growth of vaginal lactobacilli pool and C. albicans in SVF.MOS extracts in synergy with L. crispatus inhibit C. albicans adhesion in HeLa cells.Graphical

Bacterial Vaginosis and Vulvovaginal Candidiasis Pathophysiologic Interrelationship.

Among the infectious causes of vulvovaginal symptoms, bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC) dominate. Apart from infrequent mixed infections, both are considered independent and caused by unrelated pathogenic mechanisms. Clinical experience, however, is strongly suggestive that in some populations these infections are linked with recurrent BV (RBV) serving as the dominant etiopathogenic trigger for development of recurrent VVC (RVVC) with profound clinical and therapeutic consequences. The biologic basis for this critical interrelationship is discussed and suggests that as a consequence of BV dysbiosis, and not necessarily because of antibiotics prescribed, immune defenses are compromised, neutralizing vaginal yeast tolerance. The consequent BV-induced vaginal proinflammatory environment predisposes to mixed infection or consecutive episodes of post-treatment VVC. Recurrent BV and repeated antimicrobial drug exposure also predispose to acquired fluconazole resistance in C. albicans isolates, contributing to refractory vulvovaginal candidiasis.

Recurrent Vulvovaginal Candidiasis: Assessing the relationship between feminine/vaginal washes and other factors among Ghanaian women

IntroductionVulvovaginal Candidiasis (VVC) is a public health problem, with approximately 30–50% of women affected at least once during their lifetime. Recurrent Vulvovaginal Candidiasis (RVVC) is diagnosed following three or four repeated episodes of VVC in a calendar year. This condition poses health concerns with significant impacts on the quality of life of women. This cross-sectional study estimated the prevalence of RVVC and assessed the relationship between feminine/vaginal washes and other factors on RVVC among Ghanaian women in the Sekondi/Takoradi Metropolis.MethodologyA cross-sectional study was employed to gather data from 304 women. Data were collected using a pretested questionnaire. Bivariate and multivariate analyses, including chi-square/Fisher’s exact test and logistic regression, were performed using Jamovi (R Core Team 2021) software. Proportions were calculated, and odds ratios and their corresponding 95% confidence intervals were computed with the level of significance set at 0.05.ResultsThe prevalence of RVVC was estimated as 48.4% (95% CI 42.6%, 54.1%). Feminine Vaginal wash use (aOR = 3.86; 95% CI = 2.18, 6.84); age 36–45 years (aOR = 0.36; 95% CI = 0.17, 0.76) marital status (aOR = 2.37; 95% CI = 1.17, 4.79) and Sexual activity (aOR:0.43: 95%CI = 0.21, 0.88) were significantly associated with RVVC with p < 0.005.ConclusionRVVC is prevalent among women in the Sekondi/Takoradi Metropolis of Ghana. Feminine/Vaginal washes could be cautiously linked to the development of RVVC.

Therapeutic effects of medicinal plants in vulvovaginal candidiasis: a review on randomized clinical trials

Introduction: Vulvovaginal candidiasis (VVC), characterized by cheesy vaginal discharge, pain during sexual intercourse and itching is the fungal infection of female genital tract. Candida albicans is the common causative agent for this condition followed by many non-albicans Candida species. Due to the greater concern of drug resistance in Candida species, many alternative therapeutic methods have been proposed, including the use of various plant extracts. The alternate methods are effective in treating the symptomatic cases by reducing the clinical symptoms and Candida load. The objective of this review is to explore the therapeutic effectiveness of various plant extracts in vulvovaginal candidiasis. Materials and methods: A literature survey was performed in PubMed, Web of Science, Scopus and Google Scholar to find relevant clinical trials on vulvovaginal candidiasis. After the removal of duplicates, a total of 21 clinical trials were considered to evaluate the anti-Candida activity of medicinal plant products against vulvovaginal candidiasis. Results: The results of the clinical trials show that, the extracts from Curcuma longa, Zingiber officinale, Allium sativum, Zataria multiflora and Lawsonia inermis have showed potent anti-Candida activity and many other plant products were found to be as effective as the conventional drugs used. Conclusion: Due to the limited number of clinical trials available, it is difficult to come to a conclusion regarding the clinical effectiveness of various plant extracts in the effective treatment of vulvovaginal candidiasis. So, more research is needed to evaluate the effectiveness of each of these plant extracts as therapeutic alternatives to treat this condition.

Screening of Group B Streptococcal and Candida Infections in Antenatal Women Visiting a Tertiary Care Hospital and the Neonatal Outcome

Reproductive tract infections in antenatal women are frequently occurring public health concern affecting the quality of life in the infected women and further affects the neonatal outcome negatively. Vaginal infections are predominantly caused due to the disturbance in the normal vaginal microflora. Group B Streptococcus (GBS) is a major peritoneal pathogen leading to morbidity and mortality in both mother and neonates leading to complications like preterm labour, chorioamnionitis and Preterm rupture of membrane (PROM). Further, Vulvovaginal candidiasis (VVC) is a frequently encountered gynaecological disease causing morbidity in 3/4th of women at least once in their life span. It leads to infertility in non-pregnant women. It results in adverse pregnancy outcomes such as chorioamnionitis and congenital abnormalities in the neonates. The aim of this study is to screen for potential bacterial and yeast infections with focus on GBS and Candida infections and its neonatal outcome. Candida species and GBS were identified by routine culture-based tests. HiChrome agar was used for speciation of Candida species. CAMP test was performed for GBS; further identification was done using Streptococcal grouping kit. GBS was found in 15% of the antenatal women and Candida Species was found to be most common with an infection rate of 50%. Lower segment Cesarean section (LSCS) rate in GBS positive women was 60% and in Candida Non albicans positive women was found to be 65.38%. 33% of the neonates born to GBS positive mothers had respiratory distress. Infection in antenatal women negatively influenced the mode of delivery and the mean body weight of the neonates born to infected mothers were comparatively less.

Reconnoitering correlation between human papillomavirus infection-induced vaginal microecological abnormality and squamous intraepithelial lesion (SIL) progression

ObjectiveThis study aims to investigate the relationship between abnormal vaginal microecology and human papillomavirus (HPV) infection, as well as the squamous intraepithelial lesions (SIL) progression.MethodsA total of 383 patients diagnosed with HPV infection in our hospital between March 2017 and February 2022 were selected as the experimental group. In addition, several volunteers (n = 898) who underwent physical examination during the same period were randomly selected as the control group. Subsequently, we conducted several investigations, such as HPV detection and gene typing, examined vaginal microecological imbalances, and performed cytological examinations to analyze the correlation between microecological changes, different types of HPV infection, and SIL progression.ResultsHPV detection primarily included single and high-risk types of HPV infections. Moreover, significant disparities in the vaginal microecological environment between patients with persistent HPV infection and the control group, as well as patients with low-grade and high-grade SIL (LSIL and HSIL), were observed. The regression analysis revealed a correlation between LSIL and microflora density, diversity, bacteriological vaginosis (BV), vulvovaginal candidiasis (VVC), trichomonas vaginalis (TV), sialidase, as well as Lactobacillus. In addition, we identified an association between HSIL and pH, flora density, diversity, BV, VVC, candida vaginitis (CV), leukocyte esterase, catalase, and Lactobacillus levels.ConclusionThese findings revealed a significant association between abnormal vaginal microecology and both HPV infection and the SIL progression.

Inhibiting pathogenicity of vaginal Candida albicans by lactic acid bacteria and MS analysis of their extracellular compounds.

Maintaining healthy vaginal microflora post-puberty is critical. In this study we explore the potential of vaginal lactic acid bacteria (LAB) and their extracellular metabolites against the pathogenicity of Candida albicans. The probiotic culture free supernatant (PCFS) from Lactobacillus crispatus, L. gasseri, and L. vaginalis exhibit an inhibitory effect on budding, hyphae, and biofilm formation of C. albicans. LGPCFS manifested the best potential among the LAB PCFS, inhibiting budding for 24 h and restricting hyphae formation post-stimulation. LGPCFS also pre-eminently inhibited biofilm formation. Furthermore, L. gasseri itself grew under RPMI 1640 stimulation suppressing the biofilm formation of C. albicans. The PCFS from the LAB downregulated the hyphal genes of C. albicans, inhibiting the yeast transformation to fungi. Hyphal cell wall proteins HWP1, ALS3, ECE1, and HYR1 and transcription factors BCR1 and CPH1 were downregulated by the metabolites from LAB. Finally, the extracellular metabolome of the LAB was studied by LC-MS/MS analysis. L.gasseri produced the highest antifungal compounds and antibiotics, supporting its best activity against C. albicans. Vaginal LAB and their extracellular metabolites perpetuate C. albicans at an avirulent state. The metabolites produced by these LAB in vitro have been identified, and can be further exploited as a preventive measure against vaginal candidiasis.

Boric Acid for the Treatment of Vaginitis: New Possibilities Using an Old Anti‐Infective Agent: A Systematic Review

Introduction. Increasing microbial resistance to conventional pharmaceuticals calls for nonpharmaceutical treatments of vaginitis. This systematic review summarizes the efficacy of the antiseptic agent boric acid (BA) as a treatment option for microbial vaginitis in comparison to conventional therapies and proposes clinical recommendations. Materials and Methods. PubMed and Embase were searched for “boric acid” and “microbial vaginitis.” A protocol was registered on PROSPERO (CRD42020160146). Inclusion criteria included clinical trials, observational and interventional studies, including case series/reports. Exclusion criteria included in vitro and animal studies, non‐English language, and no BA treatment outcome. Primary outcomes included microbial, clinical, and complete cure. Secondary outcomes included adverse events, relapse/reinfection rates, evidence levels, microorganisms, treatment regimens, and follow‐up time. Data were extracted to a predefined Excel sheet. Results. Of 195 identified unique articles, 54 were retrieved and 41 met our inclusion criteria. Heterogeneity precluded the conduction of a meta‐analysis. Conclusion. An average cure rate of 76% was found for vulvovaginal candidiasis BA treatment. Recurrent bacterial vaginosis was controlled with BA and 5‐nitroimidazole with promising results. Maintenance BA was equal to maintenance oral itraconazole therapy in vulvovaginal candidiasis and bacterial vaginosis in a retrospective study. Prolonged BA monotherapy cured three of six recurrent Trichomonas infections. Adverse events (7.3%) were typically mild and temporary. Based on our findings and the rising antimicrobial therapy resistance, we suggest intravaginal BA 600 mg/day for 2 weeks for (recurrent) vulvovaginal candidiasis and 600 mg/day for 2‐3 weeks for recurrent bacterial vaginosis. Rare resistant Trichomonas infections can be treated with BA 600 mg × 2/day for months and in combination with oral antimicrobials. We suggest a maintenance regimen of BA 600 mg × 2/week for recurrent vulvovaginal candidiasis. In case of resistant bacterial vaginosis, we suggest BA 600 mg × 2‐3/week. Data on maintenance therapy and BA treatment of bacterial vaginosis and trichomoniasis are however limited.

Эффективность и безопасность препарата Экорутель форте, содержащего 750 мг метронидазола, 200 мг миконазола и 500 мг лактулозы, у пациенток с бактериальным вагинозом и/или кандидозным вульвовагинитом: международное многоцентровое рандомизированное контролируемое исследование

Aim: to compare the efficacy and safety of Ecorutel forte vaginal suppositories (750 mg metronidazole + 200 mg miconazole + 500 mg lactulose) and Neo-Penotran® forte vaginal suppositories (750 mg metronidazole + 200 mg miconazole) in women with bacterial vaginosis (BV) and/or vulvovaginal candidiasis (VVC). Patients and Methods: this multicenter, open-label, prospective, comparative, randomized controlled trial was conducted in parallel groups. A total of 220 women diagnosed with BV and/or VVC were included (PP population included 202 women who completed the treatment and safety population included 220 women). Women were randomized into two groups, depending on the drug. The study group (n=108) received vaginal suppositories containing 750 mg metronidazole, 200 mg miconazole, and 500 mg lactulose (Ecorutel forte). The comparison group (n=112) received vaginal suppositories containing 750 mg metronidazole and 200 mg miconazole. The efficacy of the treatment was assessed by microbiological, clinical, and overall (clinical and microbiological) recovery. In addition, treatment satisfaction and changes in lactobacilli count on day 30–35 compared to baseline were evaluated. The evidence of superior efficacy of Ecorutel forte was based on the difference between two groups with a type 1 error. Results: the analysis of the PP population on day 14–18 after the start of treatment showed that microbiological recovery occurred in 69.7% (69/99) of the women in the study group and in 53.4% (55/103) of the women in the comparison group. The difference between the two groups was 16.3% (95% CI 2.87-28.9). This difference indicates that the study drug is more effective than the comparison drug in terms of microbiological recovery at this time point (p=0.02). On day 30-35, clinical recovery was reported in 76.8% (76/99) and 66% (68/103), respectively (difference 10.8%, 95% CI 1.74-22.7, p=0.09). At this time point, the study drug demonstrated superior efficacy in terms of microbiological recovery (difference 19.5%, 95% CI 6.51-31.5, p=0.003) and overall recovery rate (difference 18.2%, 95% CI 4.66-30.8, p=0.009). A notable increase in the number of women with a lactobacillus count of 105 CFU/ml or more was observed in both groups following treatment. In the subgroup of women who received Ecorutel forte, an increase of 47.8% (95% CI 28.8-66.8, p&lt;0.05) was observed in the BV group, while in the VVC subgroup, the increase was 23.9% (95% CI 4.49-43.3, p&lt;0.05). Significant differences were observed between the groups on days 30–35 in favor of the study drug (p=0.05) at the same baseline (p=0.65). In the safety population, a significant difference between the groups was found for irritation after insertion, with 8.3% (9/108) of women experiencing this adverse event compared to 17.9% (20/112). The difference was 9.5% (95% CI 0.5-18.5, p=0.04), indicating that Ecorutel forte is more comfortable. Conclusion: Ecorutel forte demonstrated superior microbiologic efficacy compared to Neo-Penotran® forte on days 14–18 following the initiation of treatment. Furthermore, Ecorutel forte exhibited superior microbiologic efficacy and overall recovery on days 30–35 in the treatment of BV and/or VVC. KEYWORDS: bacterial vaginosis, vulvovaginal candidiasis, mixed vaginitis, lactobacilli, prebiotics, metronidazole, miconazole, lactulose. FOR CITATION: Dikke G.B., Kuz'min V.N., Yarosh E.E., Degileva I.N., Luchko S.V., Mavricheva L.A., Mos'ko T.V. Efficacy and safety of Ecorutel forte (750 mg metronidazole + 200 mg miconazole + 500 mg lactulose) in bacterial vaginosis and/or vulvovaginal candidiasis: international, multicenter, randomized, controlled trial. Russian Journal of Woman and Child Health. 2024;7(3):214–221 (in Russ.). DOI: 10.32364/2618- 8430-2024-7-3-3.

Candida species isolated in female patients of reproductive age with vaginal candidiasis in Gualeguaychú, Entre Ríos, Argentina

Objective: To identify the Candida species isolated in female patients of reproductive age with vaginal candidiasis. To determine the antifungal (ATF) sensitivity profile of the isolated Candida species. Materials and methods: Cross-sectional descriptive study, in which 124 Candida spp strains from vaginal discharge samples were isolated in Sabouraud medium supplemented with glucose. CHRO Magar Candida was used for species identification and complementary tests such as germ tube, chlamydoconidia development and investigation of trehalose assimilation were performed. In vitro sensitivity was investigated by diffusion method with ATF discs fluconazole (FLU), itraconazole (ITRA) and amphotericin B (AMB). Results: C. albicans was observed in 85.5% of the isolates followed by C. glabrata with 7.3%, C. krusei 4%, C. tropicalis 2.4% and other Candida species. For FLU, 0.9% of C. albicans, 11.1% of C. glabrata and 100% of C. krusei isolates showed resistance. For ITRA, 17% of C. albicans isolates, 55.6% of C. glabrata and 100% of C. krusei were resistant. There were no isolates resistant to AMB. Conclusion: Vaginal candidiasis continues to present Candida albicans as the main etiological agent, which is widely sensitive to ATFs. C. glabrata and C. krusei species show increased resistance to azoles. The results obtained ratify the growing need for Candida species identification tests and determination of in vitro sensitivity to ATFs in order to guide the treatment of vaginal candidiasis towards therapeutic success.

Fluconazole resistance in candida isolates from vaginal discharge in women attending an Apex Regional Sexually Transmitted Infections Center

Background: Globally, vulvovaginal candidiasis (VVC) is a common infection in women. Candida albicans is the most common agent. There is an increasing prevalence of non-albicans Candida (NAC) species, mostly in vulnerable populations, responding poorly to fluconazole, the drug of choice for VVC. It leads to treatment failure, especially in clinical isolates with intrinsic fluconazole resistance; hence, appropriate identification and antifungal susceptibility testing (AFST) are of paramount importance to ensure better clinical outcomes. Aims and Objective: The aim of this study was to identify different Candida species isolated from women with VVC and to evaluate their antifungal drug susceptibility pattern. A retrospective observational study including a total of 286 isolates of Candida spp. isolated from 729 women with vaginal discharge attending the Outpatient Department of an Apex Regional Sexually Transmitted Infections Center in North India over 1 year (June 2022–May 2023) was performed. Identification and AFST were performed as per standard microbiological procedures. Statistical analysis was carried out using the SPSS version 22.0 (SPSS Inc., Chicago, IL, USA). Data were presented as percentages and proportions. Results: Candida isolates were detected in 39.23% of women. The median age was 26–35 years. C. albicans was the most common isolate (60.8%), followed by Candida glabrata (31.8%), Candida tropicalis (4.19%), Candida parapsilosis (2.09%), Candida krusei (0.699%), and Candida kefyr (0.34%). Fluconazole resistance was seen in 29% of the isolates and susceptible dose-dependent in 32.15%. Conclusion: Increasing isolation of NAC species (39.2%) causing VVC and responding poorly to fluconazole (29% resistant strains) is a major concern. Timely and appropriate AFST will help improve the clinical outcome and quality of life.

Efficacy of Limosilactobacillus fermentum in the management of vulvovaginal candidiasis: comparative analysis with topical miconazole in a single-blind randomized clinical trial.

Vulvovaginal candidiasis (VVC) significantly impacts women's quality of life and often shows a high recurrence rate despite conventional antifungal therapies. This study evaluates the efficacy of Limosilactobacillus fermentum (LF5), a probiotic, as an alternative treatment option to conventional miconazole therapy in managing VVC. The randomized, single-blind clinical trial involved 100 premenopausal women diagnosed with VVC. Participants were assigned to either a vaginal capsule containing LF5 probiotic strain or miconazole. Treatments were administered once daily for three consecutive days. Microbiological eradication of Candida spp. and recurrence rates were assessed at 30 days post-treatment. The trial was registered with the Italian Ministry of Health. Both treatments achieved a high rate of microbiological eradication of Candida spp. within the three-day treatment period (96% for LF5 and 94% for miconazole). Recurrence rates within 2 weeks post-treatment were low and similar between the groups (10% for LF5 and 17% for miconazole). LF5 was found to have a significantly lower incidence of local adverse reactions compared to miconazole (4 vs. 12%). LF5 presents a viable alternative to miconazole for the treatment of VVC, offering comparable efficacy with fewer side effects. The results suggest that probiotic treatments can potentially enhance patient compliance and quality of life by reducing adverse reactions and recurrence rates. Further research is needed to confirm these findings in larger and more diverse populations.

Antifungal effect of Aloe barbadensis Miller gel extract on Candida albicans: Development of an eco-friendly herbal antifungal finish on cotton fabric for medical application

The application of natural antimicrobial agents has garnered significant interest within the healthcare and medical textile industries because they are functionally active textiles that can inhibit the excessive proliferation of microorganisms. The present study aimed to evaluate the antifungal properties of Aloe barbadensis Miller ethanol extract to develop an eco-friendly A. barbadensis Miller ethanolic gel treated cotton fabric against vulvovaginal candidiasis caused by Candida albicans. The antifungal activity of A. barbadensis Miller ethanol extract against C. albicans was evaluated by the well diffusion method, and the highest concentration (5 mg/ml) showed a maximum mean zone diameter of 24.00 ± 1.00 mm. Moreover, the minimum inhibitory concentration was recorded as 3.12 mg/ml by the broth macrodilution method. The cotton fabric (100% cotton) was treated with 4 mg/ml of A. barbadensis Miller ethanol extract using the pad-dry-cure method. The treated fabric exhibited a clear zone of inhibition against C. albicans using the agar diffusion method. The wash durability test showed that treated cotton fabric retained antifungal activity up to 15 washing cycles with a fungal growth reduction rate of 15%. In conclusion, A. barbadensis Miller ethanol extract showed concentration dependent inhibitory activity on C. albicans; furthermore, treated fabric also exhibited effective antifungal activity against vulvovaginal candidiasis caused by C. albicans in vitro.

СРАВНИТЕЛЬНЫЙ АНАЛИЗ КЛИНИКО-АНАМНЕСТИЧЕСКИХ ХАРАКТЕРИСТИК ПЕРВОБЕРЕМЕННЫХ ЖЕНЩИН В КРУПНОМ ПРОМЫШЛЕННОМ РЕГИОНЕ ЮГА КУЗБАССА В ЗАВИСИМОСТИ ОТ ИСХОДОВ

Objective. To identify the peculiarities of the clinical and anamnestic characteristics of first-time pregnant women with undeveloped pregnancy in a large industrial region by example of the southern agglomeration of Kuzbass. Material and methods. In the period from 01.09.2021 to 15.08.2023, 358 first-time pregnant women were observed. The main group included 172 patients with undeveloped pregnancy, the comparison group consisted of 186 women with physiologic labor. The study results were entered into MS Excel database and processed using IBM SPSS Statistics 27 program. The significance of differences was evaluated using Kolmogorov-Smirnov criteria with Lilliefors correction, Mann-Whitney, Pearson's chi-squared, and Fisher's test. Differences were considered statistically significant at p &lt; 0.05 Results. First-time pregnant women with undeveloped pregnancy were significantly less likely to have endocrine (p&lt;0,001), respiratory (p&lt;0,001), cardiovascular (p&lt;0,001), gastrointestinal (p=0,007), thyroid (p=0,016), nervous system (p&lt;0,001), visual (p&lt;0,001) and urinary (p&lt;0,001) diseases. At the same time, patients were significantly more likely to be unmarried (p&lt;0.001), live in a ‘sleeping’ area of the city (p&lt;0.001), suffer from algodismenorrhea (p=0.016), vulvovaginal candidiasis (p&lt;0.001), and their vaginal microbiota was dominated by conditionally pathogenic microflora (p &lt;0.001), elements of the removed fetal egg had inflammatory changes (p &lt;0.001). Conclusions. The first undeveloped pregnancy in somatically healthy women of early reproductive age and in the absence of an aggravated obstetric and gynecologic history prompts the search for new pathogenetic mechanisms of failed gestation.

Возможности применения препаратов рекомбинантного интерферона α-2b в комплексной терапии кандидозной инфекции слизистых оболочек у пациентов групп риска

Background: despite the availability of various antifungal medications, achieving complete relief of fungal infections can be challenging, particularly in cases where Candida spp. exhibit resistance to antimycotic agents or in patients who are at increased risk of developing candidiasis, such as those with immunosuppression, decompensated diabetes mellitus, or undergoing prolonged antibacterial treatment. The limited success of antifungal monotherapy in treating candida infections highlights the necessity for alternative treatment tactics. Aim: this study aims to assess the impact of recombinant interferon α-2b combined with antioxidants, administered as rectal suppositories, on extending the relapse-free period in high-risk patients following successful antifungal treatment of oral and genital mucosal candidiasis. Patients and Methods: the study comprised 50 patients with different forms of oral and genital mucosal candidiasis, all having insulin- independent diabetes mellitus and suboptimal glycated hemoglobin levels. Initial antifungal treatment involved drugs from the imidazole or triazole groups. Patients were then randomized into two cohorts: one receiving recombinant interferon α-2b with antioxidants (n=17) and the other receiving a placebo (n=18). Clinical outcomes and microbial content of Candida fungi were evaluated pre- and post-treatment. Results: the median age of participants was 55.5 years, with females constituting 56% (28 patients) of the cohort. Vulvovaginal candidiasis was the most prevalent diagnosis, affecting 42% of patients. The initial mean microbial load of Candida was 1.4×105 CFU/ml. Post initial antifungal treatment, 70% (35 patients) exhibited full symptom regression and marked reduction in CFU levels. The group treated with interferon α-2b experienced a mean clinical remission duration of 53.6±7.5 days, with 76.5% (13 patients) maintaining remission throughout the 60-day follow-up and CFU levels dropping below 1×103. In contrast, the placebo group had a mean remission duration of 30.1±9.6 days post- antimycotic therapy. Conclusion: integrating recombinant interferon α-2b with antioxidants into the treatment regimens for oral and genital mucosal candidiasis in high-risk patients significantly extends clinical remission periods. These findings suggest that this combination therapy could be a promising option for rehabilitation and potentially preventive interventions for patients susceptible to candida infections. KEYWORDS: Candida spp., mucosal candidiasis, diabetes mellitus, interferon alpha-2b. FOR CITATION: Zlobin D.E., Gureeva M.A., Molochkov A.V., Misnikova I.V., Polesko I.V., Guseva T.S. Possibilities of recombinant interferon α-2b drugs in the complex therapy of mucosal candidiasis infection in patients at risk. Russian Medical Inquiry. 2024;8(7):433–438 (in Russ.). DOI: 10.32364/2587-6821-2024-8-7-10.

Study of prescription pattern of antifungal drugs from tertiary care hospital

Background: The most common superficial fungal infections are tinea corporis, tinea cruris, tinea capitis, tinea pedis, tinea unguium, and tinea facie and cutaneous Candida albicans infections such as oral thrush, oropharyngeal candidiasis, vaginal candidiasis, and onychomycosis. Aims and Objectives: (i) Analysis of prescription pattern of antifungal drugs and (ii) to study common adverse effects. Materials and Methods: A retrospective, observational study conducted in B. K. L. Walawalkar Hospital, Sawarde, Ratnagiri. A total of 993 case papers were analyzed after getting approval from the institutional ethics committee and permission from dermatology department. The frequency with percentage was used for the analysis of data. Results: In 993 patients with superficial fungal infections, 523 (52.7%) were males and 470 (47.3%) were females. Majority of patients were belonged to 21–40-year age group, i.e., 439 (44.2%) followed by 41–60 years, i.e., 244 (24.6%). Our study shows that the most common superficial fungal infections with single lesion were tinea corporis (22.3%), tinea cruris (14.6%), and pityriasis versicolor (13.9%). In Candida albicans, the most common infection was onychomycosis 14 (1.4%). The most common antifungal prescribed was luliconazole (20.84%) followed by itraconazole (20.58%). The most common route was topical route (68.26%). Combination of drugs was not prescribed. Different prescription indicators were that the average number of drugs prescribed per encounter was 3.4 and average number of drugs prescribed per encounter was 2.7. Conclusion: Most commonly prescribed newer antifungal was luliconazole. Next most commonly prescribed by oral route was itraconazole. No use of combination of drugs and many drugs selected from essential medicinal list. Based on these finding we concluded prescriptions where rational approach.

Diagnostic study of fungal and bacterial pathogens that cause vaginal infection in women

Abstract Background: Vaginal infection is an inflammation of the vagina that can result in discharge, itching, and pain. A specific kind of vaginal inflammation known as bacterial vaginosis is roughing on by an overabundance of naturally occurring bacteria in the vagina, which throws the body’s delicate equilibrium out of whack. Vaginal candidiasis is a fungal infection that affects the vagina and the vulva, the tissues at the vaginal opening, causing irritation, discharge, and severe itching. Objectives: Isolation, identification, and partial purification of bacteria and fungi that cause vaginal infection. Materials and Methods: In this study, 150 vaginal samples were collected from women aged 15–55 who did not have any chronic diseases in the city of Hilla, Iraq. Cultivation of samples of bacteria on MacConkey, mannitol salt, and Eosin-methylene blue culture media and fungi on potato dextrose agar medium and chromo agar for Candida and conducting diagnostic tests for them. Results: The samples were culture on different medium. Bacteria have a percentage (55.3%) and fungi percentage (54.7%). Types of bacteria that appeared are Escherichia coli 24.3%, Klebsiella 20%, and Staphylococcus aureus 55.7%. Fungi are Candida albicans 52.6%, Candida glabrata 23.7%, and Candida krusie 23.7% have all been identified as fungi in clinical cases. Biochemical tests were performed for each sample, whether bacteria or fungi and included an examination (indol, citrate, urease, catalase, oxidase, coagulase, and H2S). Conclusion: Through results appeared S. aureus papered was found to be more common than bacteria species and fungi in clinical cases. C. albicans was found to be more common than other Candida species.

Sodium Bicarbonate: A New Promising Home Strategy for the Treatment of Vaginal Yeast Infection

Sodium Bicarbonate: A New Promising Home Strategy for the Treatment of Vaginal Yeast Infection