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British Medical Journal May 1949
Topics: Female; Humans; Inflammation; Vagina; Vaginitis; Vulvovaginitis
PubMed: 18120852
DOI: 10.1136/bmj.1.4609.808 -
BMJ (Clinical Research Ed.) Aug 1994
Topics: Adult; Candidiasis, Vulvovaginal; Cystic Fibrosis; Female; Humans
PubMed: 7993497
DOI: 10.1136/bmj.309.6952.475 -
British Medical Journal Jan 1969
Topics: Candidiasis, Vulvovaginal; Clothing; Contraceptives, Oral; Female; Humans; Pruritus Vulvae
PubMed: 5761816
DOI: 10.1136/bmj.1.5636.120-e -
Nihon Ishinkin Gakkai Zasshi = Japanese... 1998Approximately 15 % of non-pregnant women and 30 % of pregnant women yield positive cultures of Candida species in the vaginal specimens. A diagnosis of vulvovaginal... (Review)
Review
Approximately 15 % of non-pregnant women and 30 % of pregnant women yield positive cultures of Candida species in the vaginal specimens. A diagnosis of vulvovaginal candidiasis (VVC) should only be made when Candida spp. are isolated from the vulvovaginal area, together with the presence of signs and symptoms. In Japan several topical drugs for vaginal candidiasis are available, but oral azoles has not been approved. According to our studies, treatment with topical drugs resulted in symptomatic cure and negative culture conversion in 80 %-90 % of patients at the end of initial treatment (6-14 days or high-dose one day treatment according to the drug used). However Candida spp. reappeared in the vagina after several weeks in 7-34 % (according to the drug used) of initially cured cases, and some of them were again symptomatic. A small proportion of women experienced three or more episodes of symptomatic VVC annually. Repeated reinfection from a gastrointestinal reservoir or sexual transmission, subclinical presence of yeasts in the vagina, impaired host defense mechanisms, enhanced Candida virulence have been discussed as factors relating to recurrent vulvovaginal candidiasis (RVVC). Oral ketoconazole give the best result in treating RVVC, however it is not used because of possible side effects. Several studies have evaluated oral therapy for RVVC with fluconazole and itraconazole that have less side effects. However, several reports have documented the emergence of fluconazole-resistant candidiasis in long-term treatment of mycotic diseases other than VVC. The optimal treatment for RVVC remains difficult to establish.
Topics: Candidiasis, Vulvovaginal; Chronic Disease; Female; Humans; Male; Pregnancy; Pregnancy Complications, Infectious; Recurrence
PubMed: 9795266
DOI: 10.3314/jjmm.39.213 -
PloS One 2022Vulvovaginal candidiasis (VVC) is a common cause of vaginitis, but the national burden is unknown, and clinical diagnosis without diagnostic testing is often inaccurate....
Vulvovaginal candidiasis (VVC) is a common cause of vaginitis, but the national burden is unknown, and clinical diagnosis without diagnostic testing is often inaccurate. We aimed to calculate rates and evaluate diagnosis and treatment practices of VVC and recurrent vulvovaginal candidiasis (RVVC) in the United States. We used the 2018 IBM® MarketScan® Research Databases, which include health insurance claims data on outpatient visits and prescriptions for >28 million people. We used diagnosis and procedure codes to examine underlying conditions, vaginitis-related symptoms and conditions, diagnostic testing, and antibacterial and antifungal treatment among female patients with VVC. Among 12.3 million female patients in MarketScan, 149,934 (1.2%) had a diagnosis code for VVC; of those, 3.4% had RVVC. The VVC rate was highest in the South census region (14.3 per 1,000 female patients) and lowest in the West (9.9 per 1000). Over 60% of patients with VVC did not have codes for any diagnostic testing, and microscopy was the most common test type performed in 29.5%. Higher rates of diagnostic testing occurred among patients who visited an OB/GYN (53.4%) compared with a family practice or internal medicine provider (24.2%) or other healthcare provider types (31.9%); diagnostic testing rates were lowest in the South (34.0%) and highest in the Midwest (41.0%). Treatments on or in the 7 days after diagnosis included systemic fluconazole (70.0%), topical antifungal medications (19.4%), and systemic antibacterial medications (17.2%). The low frequencies of diagnostic testing for VVC and high rates of antifungal and antibacterial use suggest substantial empiric treatment, including likely overprescribing of antifungal medications and potentially unnecessary antibacterial medications. These findings support a need for improved clinical care for VVC to improve both patient outcomes and antimicrobial stewardship, particularly in the South and among non-OB/GYN providers.
Topics: Anti-Bacterial Agents; Antifungal Agents; Candidiasis, Vulvovaginal; Diagnostic Errors; Diagnostic Techniques and Procedures; Female; Humans; Male; Recurrence; United States
PubMed: 35482794
DOI: 10.1371/journal.pone.0267866 -
Journal of Infection in Developing... Aug 2022Vulvovaginal candidiasis (VVC) is a yeast infection of the vulva, which is caused by Candida species and affects women worldwide. Pregnant women are more vulnerable to... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Vulvovaginal candidiasis (VVC) is a yeast infection of the vulva, which is caused by Candida species and affects women worldwide. Pregnant women are more vulnerable to VVC due to certain risks. Moreover, their offspring are also exposed to the risk of preterm birth. In this context, ascertaining the burden of VVC is of paramount importance and this meta-analysis was conducted to estimate the occurrence of VVC among pregnant women in Africa.
METHODOLOGY
Database search was carried out through PubMed, Scopus, Science-Direct, and Google Scholar from the date of inception until December 2020. All the studies on the prevalence of VVC among African pregnant women were included in the analysis. The pooled prevalence was estimated based on the Random-effect model DerSimonian-Laird approach with Freeman- Tukey double arcsine transformed proportion. Heterogeneity was assessed using I2 test and subsequently explored using subgroup and meta-regression analysis.
RESULTS
A total of Sixteen records having a sample size 4,185 were included in this study. The overall prevalence of VVC was pooled at 29.2% (CI 95%: 23.4 - 33.0). Subgroup analysis revealed a higher prevalence in Eastern Africa, followed by Western Africa and North Africa (35%, 28%, and 15% respectively). Moderator analysis indicated that the studies that used advanced methods of detection had a higher prevalence (p = 0.048). In addition, the large sample size was associated with higher prevalence (p ≤ 0.001). No other moderators were found to be statistically significant.
CONCLUSIONS
The overall prevalence of VVC among African pregnant women is comparable to other studies worldwide. However, appropriate identification techniques and larger sample size could likely be associated with an increased prevalence. Our findings necessitate the need for further investigations to determine the geographical distribution of VVC across African regions.
Topics: Africa; Candidiasis, Vulvovaginal; Female; Humans; Infant, Newborn; Pregnancy; Pregnant Women; Premature Birth; Prevalence
PubMed: 36099366
DOI: 10.3855/jidc.15536 -
Current Opinion in Microbiology Aug 2012Diseases caused by fungi are increasingly impacting the health of the human population and now account for a large fraction of infectious disease complications in... (Review)
Review
Diseases caused by fungi are increasingly impacting the health of the human population and now account for a large fraction of infectious disease complications in individuals with impaired immunity or breached tissue defenses. Antifungal therapy is often of limited effectiveness in these patients, resulting into treatment failures, chronic infections and unacceptable rates of mortality, morbidity and their associated costs. Consequently there is a real medical need for new treatments and preventive measures to combat fungal diseases and, toward this goal, safe and efficacious vaccines would constitute major progress. After decades of complacency and neglect of this critically important field of research, remarkable progress has been made in recent years. A number of highly immunogenic and protective vaccine formulations in preclinical setting have been developed, and at least two have undergone Phase 1 clinical trials as preventive and/or therapeutic tools against candidiasis.
Topics: Aspergillosis; Candidiasis, Vulvovaginal; Cryptococcosis; Female; Fungal Vaccines; Fungi; Humans; Mycoses
PubMed: 22564747
DOI: 10.1016/j.mib.2012.04.004 -
Microbiology Spectrum Jun 2022Vulvovaginal candidiasis (VVC) is a common clinical condition with symptoms and signs of vaginal inflammation in the presence of species. At least one episode of VVC is...
Lactobacillus acidophilus, L. plantarum, L. rhamnosus, and L. reuteri Cell-Free Supernatants Inhibit Candida parapsilosis Pathogenic Potential upon Infection of Vaginal Epithelial Cells Monolayer and in a Transwell Coculture System .
Vulvovaginal candidiasis (VVC) is a common clinical condition with symptoms and signs of vaginal inflammation in the presence of species. At least one episode of VVC is experienced in up to 75% of women in the reproductive age group during their lifetime, and 5% to 8% of such women suffer from the chronic form. Most cases of VVC are still caused by C. albicans. However, the incidence of VVC cases by non-albicans Candida (NAC) species, such as C. parapsilosis, is continuously increasing. Despite the prevalence of VVC from NAC, little is known about these species and almost nothing about the mechanisms that trigger the VVC. spp. are the most widely before represented microorganisms in the vaginal microbiota of healthy women. Here, cell-free supernatants (CFS) obtained from L. acidophilus, L. plantarum, L. rhamnosus, and L. reuteri were assessed for their effect on C. parapsilosis virulence traits. Moreover, we assessed if such an effect persisted even after the removal of the CFS (CFS preincubation effect). Moreover, a transwell coculture system was employed by which the relevant antifungal effect was shown to be attributable to the compounds released by lactobacilli. Our results suggest that lactobacilli can work (i) by reducing C. parapsilosis virulence traits, as indicated by the reduced fungal proliferation, viability, and metabolic activity, and (ii) by improving epithelial resistance to the fungus. Overall, these data suggest that, in the context of the vaginal microbiota, the lactobacilli may play a role in preventing the onset of mucosal C. parapsilosis infection. The incidence of VVC by non-albicans Candida (NAC) species, such as C. parapsilosis, is increasing. Treatment failure is common in NAC-VVC because some species are resistant or poorly susceptible to the antifungal agents normally employed. Research on C. parapsilosis's pathogenic mechanisms and alternative treatments are still lacking. C. albicans triggers the VVC by producing hyphae, which favor the loss of epithelial tolerance. Differently, C. parapsilosis only produces pseudohyphae. Hence, different virulence factors may trigger the VVC. Likewise, the therapeutic options could also involve different fungal targets. Substantial and studies on the pathogenicity mechanisms of C. parapsilosis are lacking. The data presented here ascribe a novel beneficial role to different spp., whose CFS provides a postbiotic-like activity against C. parapsilosis. Further studies are needed to unravel the mechanisms involved in the bioactivities of such compounds, to better understand the role of single postbiotics in the CFS.
Topics: Antifungal Agents; Candida; Candida albicans; Candida parapsilosis; Candidiasis, Vulvovaginal; Coculture Techniques; Epithelial Cells; Female; Humans; Lactobacillus; Lactobacillus acidophilus
PubMed: 35499353
DOI: 10.1128/spectrum.02696-21 -
Journal of Clinical Laboratory Analysis Jan 2022Candida albicans is the most common and virulent genus Candida. Detection of virulence factors in this species plays an important role in the better understanding of...
BACKGROUND
Candida albicans is the most common and virulent genus Candida. Detection of virulence factors in this species plays an important role in the better understanding of pathogenesis and antifungal treatment. Molecular typing investigations are important in the epidemiological interpretation of infection. This study aimed to evaluate extracellular enzyme activity and genotyping of C. albicans species isolated from vulvovaginal samples.
METHODS
One hundred and three vaginal C. albicans isolates were tested for esterase, phospholipase, proteinase, and hemolysin activities by specific media. Besides, the DNA of C. albicans isolates was extracted and amplified for ABC genotyping.
RESULTS
The highest enzyme production of C. albicans isolates was for proteinase (97.1%) and esterase (95.2%), whereas 59.2% of C. albicans isolates were negative for hemolysin secretion. Genotype C (83.5%) was the most frequent genotype followed by genotype B (12.6%) and genotype A (3.9%).
CONCLUSION
It is concluded that genotype C was the predominant genotype in all examined vulvovaginal C. albicans isolates. Also, there was a significant difference between enzyme production in each genotype (except for proteinase).
Topics: Candida albicans; Candidiasis, Vulvovaginal; Female; Fungal Proteins; Genotype; Genotyping Techniques; Humans; Molecular Typing; Virulence Factors
PubMed: 34837715
DOI: 10.1002/jcla.24117 -
BMC Women's Health Apr 2024Vaginal microbiota evaluation is a methodology widely used in China to diagnose various vaginal inflammatory diseases. Although vaginal microbiota evaluation has many...
OBJECTIVE
Vaginal microbiota evaluation is a methodology widely used in China to diagnose various vaginal inflammatory diseases. Although vaginal microbiota evaluation has many advantages, it is time-consuming and requires highly skilled and experienced operators. Here, we investigated a six-index functional test that analyzed pH, hydrogen peroxide (HO), leukocyte esterase (LEU), sialidase (SNA), β-glucuronidase (GUS), and acetylglucossidase (NAG), and determined its diagnostic value by comparing it with morphological tests of vaginal microbiota.
MATERIALS AND METHODS
The research was conducted using data extracted from the Laboratory Information System of Women and Children's Hospital. A total of 4902 subjects, ranging in age from 35.4 ± 9.7 years, were analyzed. During the consultation, a minimum of two vaginal swab specimens per patient were collected for both functional and morphological testing. Fisher's exact was used to analyze data using SPSS.
RESULTS
Of the 4,902 patients, 2,454 were considered to have normal Lactobacillus morphotypes and 3,334 were considered to have normal dominant microbiota. The sensitivity and specificity of HO-indicating Lactobacillus morphotypes were 91.3% and 25.28%, respectively, while those of pH-indicating Lactobacillus morphotypes were 88.09% and 59.52%, respectively. The sensitivity and specificity of HO-indicating dominant microbiota were 91.3% and 25.3%, respectively, while those of pH-indicating dominant microbiota were 86.27% and 64.45%, respectively. The sensitivity and specificity of NAG for vulvovaginal candidiasis were 40.64% and 84.8%, respectively. For aerobic vaginitis, GUS sensitivity was low at 0.52%, while its specificity was high at 99.93%; the LEU sensitivity and specificity values were 94.73% and 27.49%, respectively. Finally, SNA sensitivity and specificity for bacterial vaginosis were 80.72% and 96.78%, respectively.
CONCLUSION
Functional tests (pH, SNA, HO, LEU) showed satisfactory sensitivity for the detection of vaginal inflammatory diseases. However, these tests lacked specificity, making it difficult to accurately identify specific pathologies. By contrast, NAG and GUS showed excellent specificity in identifying vaginal inflammatory diseases, but their sensitivity was limited. Therefore, functional tests alone are not sufficient to diagnose various vaginal inflammatory diseases. When functional and morphological tests are inconsistent, morphological tests are currently considered the preferred reference method.
Topics: Child; Humans; Female; Adult; Middle Aged; Hydrogen Peroxide; Vaginosis, Bacterial; Candidiasis, Vulvovaginal; Vagina; Sensitivity and Specificity
PubMed: 38582823
DOI: 10.1186/s12905-024-03035-w