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Frontiers in Immunology 2022Recurrent vulvovaginal candidiasis (RVVC) and vulvovaginal candidiasis (RVVC) are one of the most common gynecological infections, primarily caused by species. Although...
Recurrent vulvovaginal candidiasis (RVVC) and vulvovaginal candidiasis (RVVC) are one of the most common gynecological infections, primarily caused by species. Although risk factors of RVVC and VVC have been identified in many studies, antifungal immunological mechanisms are still not fully understood. We performed a 1-year prospective study in a local hospital to monitor 98 patients clinically diagnosed with gynecological infection. The results showed that 20.41% (20/98) are with RVVC, and 79.59% (78/98) patients have VVC. accounts for 90% and 96.1% of all strains isolated collected from RVVC and VVC patients, respectively. Antifungal susceptibility testing showed no significant difference in species between RVVC and VVC patients. However, the serum levels of IFN-γ, TNF-α, and IL-17F in the RVVC group were significantly lower than those of the VVC group, while IL-4, IL-6, and IL-10 were higher in the RVVC patients than VVC patients. IL-17A and IL-2 levels were comparable between the two groups. Taken together, our results suggest that the host-immune responses, especially Th1/2 immunity, may play important roles in prognosis of RVVC and VVC.
Topics: Antifungal Agents; Candida; Candida albicans; Candidiasis, Vulvovaginal; Female; Humans; Immunity; Prospective Studies; Recurrence
PubMed: 35967437
DOI: 10.3389/fimmu.2022.959740 -
Cytological diagnosis of genital ureaplasma urealyticum and its importance in cervical inflammation.European Review For Medical and... Nov 2022Cervical smear cytology, which is a gynecological cervical cancer screening test, can provide information about the presence of pathogenic microorganisms or the...
OBJECTIVE
Cervical smear cytology, which is a gynecological cervical cancer screening test, can provide information about the presence of pathogenic microorganisms or the inflammation they cause. Among them, Ureaplasma urealyticum (Uu), which is a subspecies of Mycoplasma was held responsible for high-grade cervical intraepithelial lesions and malignancy due to long-lasting complicated vulvovaginitis clinic. We aimed at investigating the role of Uu in the inflammatory process of the cervix and to describe the cytological features that enable it to be recognized microscopically in cervical smear test.
PATIENTS AND METHODS
Cervical smear and mycoplasma culture data of 123 women with complicated vulvovaginitis findings were evaluated. According to the Uu culture results, women were divided into two groups: the Uu-positive (n=59) and the Uu-negative group (n=64). The groups were compared in terms of cervical smear results, macroscopic view of the cervix, and secondary cytological evaluation results.
RESULTS
The presence of inflammatory signs (83.1%) in the Uu-positive group was observed to be 83.1%, whereas 67.2% in the Uu-negative group, and the difference between the two groups was found to be significant (p=0.04). Besides, the difference in aggregated polymorphonuclear leukocytes (PMNL) between Uu-positive group (59.3%) and Uu-negative group (40.6%) was statistically significant (p=0.04). Similarly, nuclear atypia of epithelial cells in the Uu-positive group (33.9%) was observed to be higher than in the Uu-negative group (17.2%) (p=0.03).
CONCLUSIONS
Uu causes inflammation of the cervix and cervical intraepithelial lesions. Aggregated PMNL observed in cervical smear cytology may be one of the findings that will give clues for Uu.
Topics: Female; Humans; Ureaplasma urealyticum; Cervix Uteri; Ureaplasma Infections; Early Detection of Cancer; Uterine Cervical Neoplasms; Inflammation; Vulvovaginitis
PubMed: 36394740
DOI: 10.26355/eurrev_202211_30143 -
Sao Paulo Medical Journal = Revista... Dec 2010Many factors influence occurrences of vulvovaginitis. The aims here were to assess skin color and age-related differences in the vaginal flora and occurrences of...
CONTEXT AND OBJECTIVE
Many factors influence occurrences of vulvovaginitis. The aims here were to assess skin color and age-related differences in the vaginal flora and occurrences of vulvovaginitis.
DESIGN AND SETTING
Cross-sectional study; tertiary referral hospital (Universidade Federal do Triângulo Mineiro, Uberaba).
METHODS
Healthy women who underwent routine outpatient gynecological assessments were assessed for vulvovaginitis and vaginal flora and then divided into whites (n = 13,881) and nonwhites (n = 5,295). Statistical analysis was performed using the X² test, logistic regression and odds ratios.
RESULTS
The vaginal microflora was skin-color dependent, with greater occurrence of clue cells, Trichomonas vaginalis and coccobacilli in nonwhite women (p < 0.0001). Döderlein bacilli and cytolytic flora were more prevalent in white women (p < 0.0001 and p < 0.05, respectively). The vaginal microflora was age-dependent within the skin color groups. Among the nonwhite women, clue cells were more prevalent in women aged 21 to 50 years; Trichomonas in women up to 40 years and coccobacili in women between 21 and 40 years (P < 0.05). During the proliferative and secretory phases, the nonwhite women were more likely to present clue cells, Trichomonas, Candida and coccobacilli (OR, proliferative phase: 1.31, 1.79, 1.6 and 1.25 respectively; secretory phase: 1.31, 2.88, 1.74 and 1.21 respectively), while less likely to present Döderlein flora (OR, proliferative phase: 0.76; secretory phase: 0.66), compared with white women, irrespective of age.
CONCLUSIONS
There are differences in vulvovaginitis occurrence relating to skin color, which may be associated with variations in vaginal flora.
Topics: Adolescent; Adult; Age Distribution; Aged; Aged, 80 and over; Candida; Epidemiologic Methods; Female; Gram-Negative Bacteria; Humans; Menstrual Cycle; Middle Aged; Skin Pigmentation; Trichomonas vaginalis; Vagina; Vulvovaginitis; Young Adult
PubMed: 21308158
DOI: 10.1590/s1516-31802010000600007 -
Journal of Lower Genital Tract Disease Jan 2022This series of articles, titled The Vaginal Microbiome (VMB), written on behalf of the International Society for the Study of Vulvovaginal Disease, aims to summarize the...
OBJECTIVE
This series of articles, titled The Vaginal Microbiome (VMB), written on behalf of the International Society for the Study of Vulvovaginal Disease, aims to summarize the recent findings and understanding of the vaginal bacterial microbiota, mainly regarding areas relevant to clinicians specializing in vulvovaginal disorders.
MATERIALS AND METHODS
A search of PubMed database was performed, using the search terms "vaginal microbiome" with "Candida," "vaginitis," "urinary microbiome," "recurrent urinary tract infections," "sexually transmitted infections," "human immunodeficiency virus," "human papillomavirus," "nonspecific vaginitis," "vulvodynia," and "vulvovaginal symptoms." Full article texts were reviewed. Reference lists were screened for additional articles. The third article in this series describes VMB in various urogenital disorders.
RESULTS
Variable patterns of the VMB are found in patients with vulvovaginal candidiasis, challenging the idea of a protective role of lactobacilli. Highly similar strains of health-associated commensal bacteria are shared in both the bladder and vagina of the same individual and may provide protection against urinary tract infections. Dysbiotic VMB increases the risk of urinary tract infection. Loss of vaginal lactic acid-producing bacteria combined with elevated pH, increase the risk for sexually transmitted infections, although the exact protective mechanisms of the VMB against sexually transmitted infections are still unknown.
CONCLUSIONS
The VMB may constitute a biological barrier to pathogenic microorganisms. When the predominance of lactobacilli community is disrupted, there is an increased risk for the acquisition of various vaginal pathogents. Longitudinal studies are needed to describe the association between the host, bacterial, and fungal components of the VMB.
Topics: Bacteria; Candidiasis, Vulvovaginal; Female; Humans; Lactobacillus; Microbiota; Vagina
PubMed: 34928258
DOI: 10.1097/LGT.0000000000000645 -
Revue Scientifique Et Technique... Dec 1997Contagious agalactia of small ruminants is a syndrome which principally affects the mammary glands, joints and eyes. The main causal agents are Mycoplasma agalactiae in... (Review)
Review
Contagious agalactia of small ruminants is a syndrome which principally affects the mammary glands, joints and eyes. The main causal agents are Mycoplasma agalactiae in sheep, and M. agalactiae, M. mycoides subsp. mycoides large colony type and M. capricolum subsp. capricolum in goats. In addition, M. putrefaciens can produce a similar clinical picture, particularly in goats. Contagious agalactia occurs on all five continents and is often enzootic. The evolution of the infection tends to be chronic in affected animals and herds. Symptomless shedding of mycoplasmas, mainly in the milk, may persist for a long time. These insidious infections, associated with carriage in the ears of healthy animals, are difficult to diagnose and to control. The main mode of transmission between flocks is related to the sale of carrier animals and contact during transhumance, whereas transmission within a flock occurs through contact, suckling and milking. This review discusses the clinical features, epidemiology, treatment, prevention and control of the disease.
Topics: Animals; Bacteremia; Balanitis; Female; Goat Diseases; Goats; Lactation Disorders; Male; Mastitis; Mycoplasma; Mycoplasma Infections; Mycoplasma mycoides; Pneumonia, Mycoplasma; Pregnancy; Pregnancy Complications, Infectious; Sheep; Sheep Diseases; Vulvovaginitis
PubMed: 9567311
DOI: 10.20506/rst.16.3.1062 -
Frontiers in Cellular and Infection... 2022Resistance to antifungal agents in vulvovaginal candidiasis has resulted in increasing morbidity among women globally. It is therefore crucial that new antimycotic...
Resistance to antifungal agents in vulvovaginal candidiasis has resulted in increasing morbidity among women globally. It is therefore crucial that new antimycotic agents are developed to counter this rising challenge. Q-Griffithsin (Q-GRFT) is a red algal lectin, manufactured in . Griffithsin has well characterized broad spectrum antiviral activity and has demonstrated potent activity against multiple strains of , including . We have been working to incorporate Q-GRFT into topical microbicide products to prevent HIV-1 and HSV-2 transmission. The goal of this study was to evaluate the efficacy of a prototype Q-GRFT dosage form in prophylactic and therapeutic murine models of vaginal candidiasis, through microbiologic, histopathologic, and immune studies. In a preventive model, in comparison with infected controls, Q-GRFT treatment resulted in a lower fungal burden but did not alter the number of vaginal neutrophils and monocytes. In a therapeutic model, Q-GRFT enhanced fungal clearance when compared with infected untreated controls. Finally, histopathology demonstrated lower vaginal colonization with following Q-GRFT treatment. Our results demonstrate that Q-GRFT has significant preventive and therapeutic activity in vaginal candidiasis offering additional benefit as a topical microbicide for prevention of HIV-1 and HSV-2 transmission.
Topics: Mice; Female; Humans; Animals; Antiviral Agents; Plant Lectins; Candidiasis, Vulvovaginal; Disease Models, Animal; Lectins; HIV-1; Herpesvirus 2, Human; Anti-Infective Agents, Local
PubMed: 36329822
DOI: 10.3389/fcimb.2022.976033 -
Frontiers in Immunology 2022Vulvovaginal candidiasis (VVC) is characterized by symptomatic inflammatory responses in the vagina caused by and non-albicans (NAC) species. The epidermal growth...
Vulvovaginal candidiasis (VVC) is characterized by symptomatic inflammatory responses in the vagina caused by and non-albicans (NAC) species. The epidermal growth factor receptor (EGFR) -mitogen-activated protein kinase (MAPK) signaling pathway has been linked to immune responses of oral mucosa after exposure, but whether this pathway plays a similar response in vaginal epithelial cells is not known. Here, we observed that phosphorylation of EGFR and p38 was continuously activated in vaginal epithelial cells by strain SC5314. This differs markedly from oral epithelial cells, which respond in a biphasic manner in order to properly discriminate the morphology of . When compared with SC5314, a highly azole-resistant isolate 1052 can induce a stronger phosphorylated signal of EGFR and p38, while clinically-isolated NAC strains including , , and trigger higher levels of phosphorylated ERK1/2 and c-Fos than . Inhibition of EGFR significantly reduces inflammatory response and epithelial damage induced by both and , while inhibition of p38 leads to significant repair of epithelial damage triggered by both and NAC species. These results confirm the importance of the EGFR-MAPK signaling in VVC pathogenesis and highlight the remarkable immunogenic differences between and NAC species in host-microbe interactions.
Topics: Candida; Candida albicans; Candida glabrata; Candidiasis, Vulvovaginal; ErbB Receptors; Female; Humans; Immunity; Intercellular Signaling Peptides and Proteins; Mitogen-Activated Protein Kinases; Mitogens
PubMed: 35720274
DOI: 10.3389/fimmu.2022.894069 -
Journal of Investigative Medicine High... 2022Recurrent vulvovaginal candidiasis is a common disorder which causes significant morbidity among women worldwide, and treatment options are limited. Ibrexafungerp is a...
Recurrent vulvovaginal candidiasis is a common disorder which causes significant morbidity among women worldwide, and treatment options are limited. Ibrexafungerp is a novel antifungal agent which was approved in 2021 for treatment of vulvovaginal candidiasis. We present a case of recurrent vulvovaginal candidiasis successfully treated with ibrexafungerp.
Topics: Antifungal Agents; Candidiasis, Vulvovaginal; Drug Resistance, Fungal; Female; Fluconazole; Glycosides; Humans; Triterpenes
PubMed: 36059275
DOI: 10.1177/23247096221123144 -
BMC Women's Health May 2022Vulvovaginal candidiasis (VVC) is a common gynecologic problem in the United States but estimates of its true incidence and prevalence are lacking. We estimated...
BACKGROUND
Vulvovaginal candidiasis (VVC) is a common gynecologic problem in the United States but estimates of its true incidence and prevalence are lacking. We estimated self-reported incidence and lifetime prevalence of healthcare provider-diagnosed VVC and recurrent VVC (RVVC), assessed treatment types, and evaluated demographic and health-related risk factors associated with VVC.
METHODS
An online survey sent to 4548 U.S. adults; data were weighted to be representative of the population. We conducted descriptive and bivariate analyses to examine demographic characteristics and health related factors associated with having VVC in the past year, lifetime prevalence of VVC, and over-the-counter (OTC) and prescription antifungal treatment use. We conducted multivariate analyses to assess features associated with 1) having VVC in the past year, 2) number of VVC episodes in the past year, and 3) lifetime prevalence of VVC.
RESULTS
Among the subset of 1869 women respondents, 98 (5.2%) had VVC in the past year; of those, 5 (4.7%) had RVVC. Total, 991 (53%) women reported healthcare provider-diagnosed VVC in their lifetime. Overall, 72% of women with VVC in the past year reported prescription antifungal treatment use, 40% reported OTC antifungal treatment use, and 16% reported both. In multivariate analyses, odds of having VVC in the past year were highest for women with less than a high school education (aOR = 6.30, CI: 1.84-21.65), with a child/children under 18 years old (aOR = 3.14, CI: 1.58-6.25), with diabetes (aOR = 2.93, CI: 1.32-6.47), who were part of a couple (aOR = 2.86, CI: 1.42-5.78), and with more visits to a healthcare provider for any reason (aOR = 2.72, CI: 1.84-4.01). Similar factors were associated with increasing number of VVC episodes in the past year and with lifetime prevalence of VVC.
CONCLUSION
VVC remains a common infection in the United States. Our analysis supports known clinical risk factors for VVC and suggests that antifungal treatment use is high, underscoring the need to ensure appropriate diagnosis and treatment.
Topics: Adolescent; Adult; Antifungal Agents; Candidiasis, Vulvovaginal; Child; Female; Humans; Incidence; Male; Prevalence; Self Report; Surveys and Questionnaires; United States
PubMed: 35538480
DOI: 10.1186/s12905-022-01741-x -
American Family Physician Jun 2000Vulvovaginal candidiasis is considered recurrent when at least four specific episodes occur in one year or at least three episodes unrelated to antibiotic therapy occur... (Review)
Review
Vulvovaginal candidiasis is considered recurrent when at least four specific episodes occur in one year or at least three episodes unrelated to antibiotic therapy occur within one year. Although greater than 50 percent of women more than 25 years of age develop vulvovaginal candidiasis at some time, fewer than 5 percent of these women experience recurrences. Clinical evaluation of recurrent episodes is essential. Patients who self-diagnose may miss other causes or concurrent infections. Known etiologies of recurrent vulvovaginal candidiasis include treatment-resistant Candida species other than Candida albicans, frequent antibiotic therapy, contraceptive use, compromise of the immune system, sexual activity and hyperglycemia. If microscopic examination of vaginal secretions in a potassium hydroxide preparation is negative but clinical suspicion is high, fungal cultures should be obtained. After the acute episode has been treated, subsequent prophylaxis (maintenance therapy) is important. Because many patients experience recurrences once prophylaxis is discontinued, long-term therapy may be warranted. Patients are more likely to comply when antifungal therapy is administered orally, but oral treatment carries a greater potential for systemic toxicity and drug interactions.
Topics: Antifungal Agents; Boric Acids; Candidiasis, Vulvovaginal; Clotrimazole; Drug Interactions; Female; Fluconazole; Humans; Ketoconazole; Patient Education as Topic; Recurrence; Risk Factors; Teaching Materials; Time Factors; Triazoles
PubMed: 10865926
DOI: No ID Found