Candidiasis, also known as candidiasis vulvovaginitis, is an infection caused by different types of Candida fungi, the most frequent being Candida albicans. The present study reports an effective strategy, which opens...Candidiasis, also known as candidiasis vulvovaginitis, is an infection caused by different types of Candida fungi, the most frequent being Candida albicans. The present study reports an effective strategy, which opens new avenues for the treatment of this public health problem. The MAC<sup>®</sup> Methodology, conventional laser light-emitting (LLLT)/LED) methods are based on the biphasic response demonstrated many times in LLLT research and as with other forms of drugs, a “drug” (irradiation parameters) and a “dose” (irradiation times) and the “Arndt-Schulz Law” is often cited as a suitable model to describe the dose-dependent effects of LLLT. This method uses photopharmaceuticals, cell markers and the use of correct parameters for each case to induce the acceleration of tissue repair. The present study shows a case of a 32-year-old patient diagnosed with recurrent candidiasis 4 years ago. Eighteen sessions were performed (every other day) using a photoactivated component (Methylene blue 1% + Clotrimazole 1%) and LED phototherapy (red, blue and violet) with emission times of 60 - 260 seconds for each applicator, according to the dose recommendations of the scar acceleration method (MAC<sup>®</sup>). At the sixth treatment session there was a noticeable decrease in the itching sensation reported by the patient. In session 11 she reported feeling a great improvement, indicating that she no longer felt itching in any area after 18 sessions. The present case demonstrates new methodologies to treat common problems in the population that have a positive impact on the quality of life. This methodology has a promising future because it is non-invasive and requires a great biological transformation for inflammatory, fungal and viral control.展开更多
Objective: To evaluate the alpha-defensin (α-DF) genes polymorphism in women with vulvovaginal candidiasis and recurrence. Methods: This observational study included clinical vaginal secretion samples collected over ...Objective: To evaluate the alpha-defensin (α-DF) genes polymorphism in women with vulvovaginal candidiasis and recurrence. Methods: This observational study included clinical vaginal secretion samples collected over four years from 88 women, ranging in age from 18 to 65 years, from medical centers of Sao Paulo and Mogi das Cruzes, Brazil. Thirty-six of these women were asymptomatic (control group) and 52 presented clinical condition compatible with vulvovaginitis (38 primary or episodic as non-recurrent forms, and 14 recurrent vulvovaginal candidiasis). A portion of each sample was plated on Sabouraud dextrose agar with chloramphenicol and grown on CHROMagar Candida for presumptive characterization. The identification of the species was obtained by sequencing of the ITS1 region of rDNA. α-DF genes were amplified for subsequent evaluation of polymorphisms by endonuclease restriction assay. Results: From 88 samples were isolated 60 Candida albicans and 28 non-albicans Candida spp. Resistant C. albicans strains and non-albicans Candida spp. were more prevalent in recurrence. In all groups, the number of resistant non-albicans Candida spp. was most high than susceptible strains. α-DF1, α-DF3 and α-DF1/α-DF3 genotypes were found in 32 (36.4%), 17 (19.3%), 6 (6.8%) vaginal samples, respectively. About 33 samples were not amplified. Recurrence and severe disease were more observed in homozygous population. Conclusions: Non-albicans Candida spp. and homozygotic α-DF genotipes (α-DF1 and α-DF3) were more related with severe clinical signs and recurrence. Further studies about vulvovaginal candidiasis and α-DF genes are necessary to access the more comprehensive role of defensins in clinical manifestations.展开更多
Objective To investigate the features of vaginal bacteria community in women with recurrent vulvovaginal candidiasis （R VVC） and its etiological risk in vaginal health. Methods Totally 237 reproductive-aged women wi...Objective To investigate the features of vaginal bacteria community in women with recurrent vulvovaginal candidiasis （R VVC） and its etiological risk in vaginal health. Methods Totally 237 reproductive-aged women with RVVC in an acute episode were studied. Whereas 230 healthy reproductive-aged women were enrolled as the control. The vaginal pH was evaluated, while vaginal secretions were sampled for Gram＇s staining and oilmicroscopy. By Nugent score system, the composition of vaginal communities was determined, and other micro-ecological features were approached. To describe other features of vaginal microbiota, the community＇s bacteria density, species diversity and predominant species were evaluated at 1 000 X magnification. Results The vaginal pH （4.53 ~ 0.30） and Nugent score （4.31 ___＋ O. 73） in RVVC group were significantly increased compared with vaginal pH （4.11 __＋ 0.30） and Nugent score （1.32 _＋ 1.29） in control group （P〈O.05, respectively）. The density of Lactoba- cillus in RVVC group was significantly lower than that in control group （P〈O.05）, while the densities of Gardnerella vaginalis, Gram-positive cocci and other species were significantly higher respectively than those in control group （P〈O. 05）. Species diversity of women with RVVC significantly exceeded that of control group （P〈O.05）. More than half of vaginal communities in R VVC group lost Lactobacillus-dominating and were predominated by other bacteria such as Gardnerella vaginalis and Gram-positive cocci. The prevalence of Gardnerella vaginalis-dominating and Gram-positive cocci-domi- nating communities in RVVC group （37.55% and 19.83%） were significantly higher than those in control group （1.30% and 1.73%） （P〈0.05）. Conclusion The significant changes in vaginal bacterial community were observed in RVVC women. Such variations in community might relate to vaginal biological barrier compromising and increase the risk to the recurrence of VVC. It is still controversial whether probiotics can prevent recurrences of VVC, and more randomized, doubleblind, placebo-controlled trials with a larger sample size should be carried out, so as to clarify its effects for the prophylaxis of RVVC.展开更多
Inflammation of the vagina and vulva caused by Candida is called vulvovaginal candidiasis(VVC).Risk factors for VVC include pregnancy,diabetes mellitus,frequent oral sexual intercourse,and the use of tight synthetic u...Inflammation of the vagina and vulva caused by Candida is called vulvovaginal candidiasis(VVC).Risk factors for VVC include pregnancy,diabetes mellitus,frequent oral sexual intercourse,and the use of tight synthetic underwear and systemic antibiotics.Candida albicans,which belongs to the normal flora of the vagina,is the most common cause of VVC.However,an increase in VVC episodes caused by non-albicans Candida species,including Candida glabrata,Candida tropicalis,Candida krusei and Candida parapsilosis,has been reported.In this study,a total of 100 Candida isolates obtained from patients with vaginitis symptoms were evaluated.The susceptibility of the Candida strains to amphotericin B,itraconazole,fluconazole,ketoconazole,voriconazole and caspofungin was investigated using the reference broth microdilution method.Risk factors and demographic characteristics of the patients and the identified Candida species were also investigated.Among the 100 Candida strains isolated from vaginal samples,47(47%)were C.albicans,43(43%)C.glabrata,5(5%)C.kefyr,2(2%)C.krusei,2(2%)C.tropicalis and 1(1%)was Candida guilliermondii.The incidences of Candida susceptibility to caspofungin,fluconazole,itraconazole,voriconazole,ketoconazole and amphotericin B were 75%,35%,27%,80%,97%and 100%,respectively.Also,there was a significant difference in antifungal susceptibility among patients belonging to certain risk groups,such as patients previously using antibiotics and recurrent cases.Prevalence of non-albicans Candida species and antifungal resistance,especially against azoles,are both increasing,and certain risk factors should be monitored strictly.展开更多
OBJECTIVE:To summarize and evaluate the effectiveness and safety of Redcore lotion on treating vulvovaginal candidiasis(VVC)using a systematic review and Meta-analysis of randomized controlled trials.METHODS:A systema...OBJECTIVE:To summarize and evaluate the effectiveness and safety of Redcore lotion on treating vulvovaginal candidiasis(VVC)using a systematic review and Meta-analysis of randomized controlled trials.METHODS:A systematic literature search was performed in five English and three Chinese electronic databases up to October 2019.Randomized controlled trials in the treatment for VVC were included;only studies which compared the effectiveness and safety of Redcore lotion plus miconazole with miconazole alone were included.Relative risk(RR)and 95%confidence intervals(CI)were used in the Meta-analysis.RESULTS:Seven studies involving 768 patients suffering from VVC were identified;468 of the patients were pregnant women(60.9%).Combination group(Redcore lotion plus miconazole)was more effective in redu CIng symptomatic episodes of VVC than miconazole alone,with respect to cure rate(RR,1.31;95%CI,1.09-1.57;P=0.01),fungal culture negative rate(RR,1.21;95%CI,1.04-1.41;P=0.01),and effective rate(RR,1.18;95%CI,1.05-1.35;P=0.01).Subgroup analyses for pregnant women also showed that the combination group had superior outcomes with respect to VVC cure rate(RR,1.48;95%CI,1.16-1.88,P<0.01),fungal culture negative rate(RR,1.26;95%CI;1.09-1.47;P<0.01),and effective rate(RR,1.25;95%CI,1.10-1.42;P<0.01).Additionally,the observed risk of adverse events was lower in the combination medication group(RR,0.30;95%CI,0.14-0.65;P<0.01).CONCLUSIONS:Though overall quality of individual studies was low,Redcore lotion plus miconazole can significantly improve clinical effectiveness and safety compared with miconazole alone.展开更多
Summarizing two cases of vaginal candidiasis,cured by integrated traditional Chinese and western medicine in clinical work,it is found that the combination of traditional Chinese and western medicine has a significant...Summarizing two cases of vaginal candidiasis,cured by integrated traditional Chinese and western medicine in clinical work,it is found that the combination of traditional Chinese and western medicine has a significant effect on the treatment of this disease.The curative effect is outstanding,and the recurrence rate is significantly reduced,which can be used as a reference for gynecological medical workers.展开更多
In order to analyze the in vivo expression of Candida albicans secreted aspartyl pro- teinases (SAP) in human vaginal infection, the vaginal secretion from 29 human subjects was col- lected by vaginal swab, and the ex...In order to analyze the in vivo expression of Candida albicans secreted aspartyl pro- teinases (SAP) in human vaginal infection, the vaginal secretion from 29 human subjects was col- lected by vaginal swab, and the expression of SAP1–SAP6 was detected by reverse-transcriptase po- lymerase chain reaction using specific primer sets. It was found that Sap2 and Sap5 were the most common genes expressed during infection; Sap3 and Sap4 were detected in all subjects and all 6 SAP genes were simultaneously expressed in some patients with vaginal candidiasis. It was suggested that the SAP family is expressed by Candida albicans during infection in human and that Candida albi- cans infection is associated with the differential expression of individual SAP genes which may be involved in the pathogenesis of vaginal candidiasis.展开更多
<b style="line-height:1.5;"><span style="font-family:Verdana;">Background:</span></b><span "="" style="line-height:1.5;"><span style="...<b style="line-height:1.5;"><span style="font-family:Verdana;">Background:</span></b><span "="" style="line-height:1.5;"><span style="font-family:Verdana;"> Vaginitis refers to any inflammation or infection of the vagina. This is a common gynecological problem found in women of all ages, with one-third of women having at least one form of vaginitis at some time during their lives. The vagina is the muscular passageway between the uterus and the external genital area. When the walls of the vagina become inflamed, because some irritant has disturbed the balance of the vaginal area, vaginitis can occur. The most common types of vaginitis are: Candida or “yeast” infection, Bacterial vaginosis, Trichomoniasis vaginitis. </span><b><span style="font-family:Verdana;">Objectives of Study:</span></b><span style="font-family:Verdana;"> Therefore, the present study was carried out to determine the prevalence of bacterial vaginosis (BV), vulvovaginal candidiasis (VVC) among married and unmarried women and evaluat</span></span><span style="line-height:1.5;font-family:Verdana;">e</span><span "="" style="line-height:1.5;"><span style="font-family:Verdana;"> the association socio-demographic risk factors and symptoms-related variables in women attending gynecology clinic in Hargeisa group hospital. </span><b><span style="font-family:Verdana;">Methodology:</span></b><span style="font-family:Verdana;"> A total of 150 married and unmarried women w</span></span><span style="line-height:1.5;font-family:Verdana;">ere</span><span style="line-height:1.5;font-family:Verdana;"> investigated & diagnosed by a researcher in Hargeisa Group Hospital, Hargeisa City, Somaliland for determin</span><span style="line-height:1.5;font-family:Verdana;">ing</span><span "="" style="line-height:1.5;"><span style="font-family:Verdana;"> of VVI prevalence in the present study. Vaginal swabs from these patients were processed for detection of bacterial vaginosis (BV), VVC and trichomoniasis based on guidelines of management of vagina infection. Species specific distribution of VVC was assessed by cultured of </span><i><span style="font-family:Verdana;">Candida</span></i><span style="font-family:Verdana;"> on differential agar media, Germ tube test, rice meal agar and carbohydrates fermentation test and BV diagnosed by us</span></span><span style="line-height:1.5;font-family:Verdana;">ing</span><span "="" style="line-height:1.5;"><span style="font-family:Verdana;"> gram staining test and biochemical testes. The nurse interviewers performed a comprehensive review of patients and completed the standardized baseline questionnaire containing information regarding the association socio-demographic risk factors and symptoms-related. </span><b><span style="font-family:Verdana;">Results & Discussion: </span></b><span style="font-family:Verdana;">The findings of the present study indicate that VVC was the most prevalent infection with 68 (45%) followed by BV 43 (29%). However, no case of trichomoniasis was detected. </span><i><span style="font-family:Verdana;">Candida albicans</span></i><span style="font-family:Verdana;"> was found to be the most prevalent species with 47</span></span><span "="" style="line-height:1.5;"> </span><span "="" style="line-height:1.5;"><span style="font-family:Verdana;">(60.3%). Out of non-albicans </span><i><span style="font-family:Verdana;">Candida</span></i><span style="font-family:Verdana;"> (NAC) species, </span><i><span style="font-family:Verdana;">C.</span></i></span><i style="line-height:1.5;"><span "=""> </span></i><i style="line-height:1.5;"><span style="font-family:Verdana;">tropicali</span></i><i style="line-height:1.5;"><span style="font-family:Verdana;">s</span></i><span "="" style="line-height:1.5;"><span style="font-family:Verdana;"> was found to be 9 (9.9%) and </span><i><span style="font-family:Verdana;">C.</span></i></span><i style="line-height:1.5;"><span "=""> </span></i><i style="line-height:1.5;"><span style="font-family:Verdana;">glabrata </span></i><span style="line-height:1.5;font-family:Verdana;">7</span><span "="" style="line-height:1.5;"> </span><span "="" style="line-height:1.5;"><span style="font-family:Verdana;">(12.2%). On the other hand, the results of present study indicated that BV species </span><i><span style="font-family:Verdana;">Gardnerella vaginalis</span></i><span style="font-family:Verdana;"> was most causative with</span><i> </i><span style="font-family:Verdana;">22</span></span><span "="" style="line-height:1.5;"> </span><span "="" style="line-height:1.5;"><span style="font-family:Verdana;">(19</span><i><span style="font-family:Verdana;">.</span></i><span style="font-family:Verdana;">5) and</span></span><span "="" style="line-height:1.5;"> <i><span style="font-family:Verdana;">Lactobacillus spp</span></i><span style="font-family:Verdana;">. was 14</span></span><span "="" style="line-height:1.5;"> </span><span style="line-height:1.5;font-family:Verdana;">(9.3%)</span><span style="line-height:1.5;font-family:Verdana;">.</span><i style="line-height:1.5;"><span "=""> </span></i><span style="line-height:1.5;font-family:Verdana;">These results were also confirmed by gram staining test and biochemical testes. When VVI w</span><span style="line-height:1.5;font-family:Verdana;">as</span><span style="line-height:1.5;font-family:Verdana;"> compared among married and unmarried women, VVC was more prevalent in married women 47</span><span "="" style="line-height:1.5;"> </span><span style="line-height:1.5;font-family:Verdana;">(31.96) while, BV w</span><span style="line-height:1.5;font-family:Verdana;">as</span><span style="line-height:1.5;font-family:Verdana;"> more prevalent in unmarried women with 32</span><span "="" style="line-height:1.5;"> </span><span style="line-height:1.5;font-family:Verdana;">(13.76)</span><span style="line-height:1.5;font-family:Verdana;">,</span><span style="line-height:1.5;font-family:Verdana;"> discussed these results detected that prevalent found most highly with VVB and BV while, no case of trichomoniasis was detected. These findings are in consonance with various previous studies which have indicated VVC & BV to be the most prevalent in VI. Furthermore, the study showed statistical significant difference (P</span><span "="" style="line-height:1.5;"> </span><span style="line-height:1.5;font-family:Verdana;"><</span><span "="" style="line-height:1.5;"> </span><span style="line-height:1.5;font-family:Verdana;">0.005) & relationship among prevalence of VVV & BV and some socio-demo</span><span "="" style="line-height:1.5;"><span style="font-family:Verdana;">graphic risk factors and some symptoms which have been identified as causes of variation in the prevalence rates of bacterial vaginosis & vagina candidasis. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> VVC was the most prevalent VVI followed by BV in Hargeisa City. </span><i><span style="font-family:Verdana;">C. albicans</span></i><span style="font-family:Verdana;"> was the most prevalent species in VVC while among BV species, </span><i><span style="font-family:Verdana;">Gardnerella vaginalis was </span></i><span style="font-family:Verdana;">found to occur at highest frequency. However, further studies are needed to assess specific diagnosis and role of clinical risk factors. Urgent action is required to improve vagina infection control measures to reduce the prevalence and make new policies for treatment of vagina infection in HGH.展开更多
Purpose: To evaluate the profile of in vitro susceptibility of yeasts isolated from cases of primary and espisodic vulvovaginitis to two antifungal agents. Methods: 40 Candida isolates from episodes of vulvovaginal ca...Purpose: To evaluate the profile of in vitro susceptibility of yeasts isolated from cases of primary and espisodic vulvovaginitis to two antifungal agents. Methods: 40 Candida isolates from episodes of vulvovaginal candidiasis were identified by classic methodologies. The susceptibility testing of the in vitro fluconazole and ketoconazole activity against the isolates was accessed by E-test. Results: C. albicans was the most common species identified in 70% of the occurrences followed by C. glabrata (20%), C. tropicalis (7.5%), and C. guilliermondii (2.5%). In the susceptibility profile to antifungal agents, 12.5% and 16.7% of the isolates obtained from primary and episodic vulvovaginal candidiasis were resistant to fluconazole, respectively. To ketoconazole, we found that 6.25% and 12.5% of the isolates respectively from primary vulvovaginal candidiasis (PVVC) and episodic vulvovaginal candidiasis (EVVC) had high MIC values. Conclusions: E-test is a reliable method for the susceptibility testing of Candida spp. due to its simplicity, reproducibility, and lack of specialized equipment. Resistant strains and non-albicans species were verified more in cases of EVVC than in PVVC. Clinical and mycological cure of patients with episodic vulvovaginal candidiasis or complicated cases occurred after prolonged treatment and sometimes with multiple antifungals use.展开更多
Background： Vulvovaginal candidiasis （WC） was a common infection associated with lifelong harassment of woman＇s social and sexual life. The purpose of this study was to describe the species distribution and in vit...Background： Vulvovaginal candidiasis （WC） was a common infection associated with lifelong harassment of woman＇s social and sexual life. The purpose of this study was to describe the species distribution and in vitro antifungal susceptibility of Candida species （Candida spp.） isolated from patients with VVC over 8 years. Methods： Species which isolated from patients with VVC in Peking University First Hospital were identified using chromogenic culture media. Susceptibility to common antifungal agents was determined using agar diffusion method based on CLSI M44-A2 document. SPSS software （version 14.0, Inc., Chicago, IL, USA） was used for statistical analysis, involving statistical description and Chi-square test. Results： The most common strains were Candida （C.） albicans, 80.5% （n = 1775） followed by C. glabrata, 18.1% （n = 400）. Nystatin exhibited excellent activity against all species （〈4% resistant JR]）. Resistance to azole drugs varied among different species. C. albicans： clotrimazole （3.1% R） 〈 fluconazole （ 16.6% R） 〈 itraconazole （51.5% R） 〈 mieonazole （54.0% R）, C. glabrata： miconazole （25.6% R） 〈 clotrimazole （50.5% R） 〈 itraconazole （61.9% R） 〈 fluconazole （73.3% R）; Candida krusei： clotrimazole （0 R） 〈 fluconazole （57.7% R） 〈 miconazole （73.1% R） 〈 itraconazole （83.3% R）. The susceptibility of fluconazole was noticeably decreasing among all species in the study period. Conclusions： Nystatin was the optimal choice for the treatment of VVC at present. The species distribution and in ~＇itro antifungal susceptibility of Candida spp. isolated from patients with VVC had changed over time.展开更多
Objective: The effect of alterations in vaginal flora during pregnancy remains uncertain. We compared the flora distribution in women with spontaneous abortion(SA) and those in normal condition.Methods: Samples of vag...Objective: The effect of alterations in vaginal flora during pregnancy remains uncertain. We compared the flora distribution in women with spontaneous abortion(SA) and those in normal condition.Methods: Samples of vaginal discharge were obtained from 3,233 women attending the Gynecological and Public Health Centre of our hospital from January 2010 to December 2013. Pathogen culture testing was performed by the Microbiological Diagnostic Centre of our hospital, including SA group(n= 1,513), normal first-trimester group(NP group, n = 908), and nonpregnant women(control group, n= 812).Results: Of 3,233 vaginal discharge samples, 425 samples(13.15%) were positive for pathogen. The pathogen detection rate was19.96%(302/1,513), 7.93%(72/908), and 6.28%(51/812) in the SA, NP, and control groups, respectively. The five most common bacteria were Enterococcus faecalis, Candida albicans, Escherichia coli, group B Streptococcus(GBS), and Ureaplasma urealyticum(Uu) in the SA group; Uu, C. albicans, Candida tropicalis, GBS, and E.faecalis in the NP group; and Candida glabrata, Uu, E. coli, Gardnerella vaginalis,and C. albicans in the control group.Conclusions: In the SA group, the pathogen detection rate was markedly elevated. An infection of Candida sp. in pregnant women was relatively common. In routine antenatal care, overtreatment is not recommended in asymptomatic candidiasis. There was no significant difference in the detection rate of Uu between the SA group and the other two groups, suggesting that it does not cause SA.展开更多
文摘Candidiasis, also known as candidiasis vulvovaginitis, is an infection caused by different types of Candida fungi, the most frequent being Candida albicans. The present study reports an effective strategy, which opens new avenues for the treatment of this public health problem. The MAC<sup>®</sup> Methodology, conventional laser light-emitting (LLLT)/LED) methods are based on the biphasic response demonstrated many times in LLLT research and as with other forms of drugs, a “drug” (irradiation parameters) and a “dose” (irradiation times) and the “Arndt-Schulz Law” is often cited as a suitable model to describe the dose-dependent effects of LLLT. This method uses photopharmaceuticals, cell markers and the use of correct parameters for each case to induce the acceleration of tissue repair. The present study shows a case of a 32-year-old patient diagnosed with recurrent candidiasis 4 years ago. Eighteen sessions were performed (every other day) using a photoactivated component (Methylene blue 1% + Clotrimazole 1%) and LED phototherapy (red, blue and violet) with emission times of 60 - 260 seconds for each applicator, according to the dose recommendations of the scar acceleration method (MAC<sup>®</sup>). At the sixth treatment session there was a noticeable decrease in the itching sensation reported by the patient. In session 11 she reported feeling a great improvement, indicating that she no longer felt itching in any area after 18 sessions. The present case demonstrates new methodologies to treat common problems in the population that have a positive impact on the quality of life. This methodology has a promising future because it is non-invasive and requires a great biological transformation for inflammatory, fungal and viral control.
基金This study was financially supported by the Brazilian National Council for Scientific and Technological Development(CNPq,Brazil)We thank to Claudia R.C.Porto for support in laboratory tests.
文摘Objective: To evaluate the alpha-defensin (α-DF) genes polymorphism in women with vulvovaginal candidiasis and recurrence. Methods: This observational study included clinical vaginal secretion samples collected over four years from 88 women, ranging in age from 18 to 65 years, from medical centers of Sao Paulo and Mogi das Cruzes, Brazil. Thirty-six of these women were asymptomatic (control group) and 52 presented clinical condition compatible with vulvovaginitis (38 primary or episodic as non-recurrent forms, and 14 recurrent vulvovaginal candidiasis). A portion of each sample was plated on Sabouraud dextrose agar with chloramphenicol and grown on CHROMagar Candida for presumptive characterization. The identification of the species was obtained by sequencing of the ITS1 region of rDNA. α-DF genes were amplified for subsequent evaluation of polymorphisms by endonuclease restriction assay. Results: From 88 samples were isolated 60 Candida albicans and 28 non-albicans Candida spp. Resistant C. albicans strains and non-albicans Candida spp. were more prevalent in recurrence. In all groups, the number of resistant non-albicans Candida spp. was most high than susceptible strains. α-DF1, α-DF3 and α-DF1/α-DF3 genotypes were found in 32 (36.4%), 17 (19.3%), 6 (6.8%) vaginal samples, respectively. About 33 samples were not amplified. Recurrence and severe disease were more observed in homozygous population. Conclusions: Non-albicans Candida spp. and homozygotic α-DF genotipes (α-DF1 and α-DF3) were more related with severe clinical signs and recurrence. Further studies about vulvovaginal candidiasis and α-DF genes are necessary to access the more comprehensive role of defensins in clinical manifestations.
文摘Objective To investigate the features of vaginal bacteria community in women with recurrent vulvovaginal candidiasis （R VVC） and its etiological risk in vaginal health. Methods Totally 237 reproductive-aged women with RVVC in an acute episode were studied. Whereas 230 healthy reproductive-aged women were enrolled as the control. The vaginal pH was evaluated, while vaginal secretions were sampled for Gram＇s staining and oilmicroscopy. By Nugent score system, the composition of vaginal communities was determined, and other micro-ecological features were approached. To describe other features of vaginal microbiota, the community＇s bacteria density, species diversity and predominant species were evaluated at 1 000 X magnification. Results The vaginal pH （4.53 ~ 0.30） and Nugent score （4.31 ___＋ O. 73） in RVVC group were significantly increased compared with vaginal pH （4.11 __＋ 0.30） and Nugent score （1.32 _＋ 1.29） in control group （P〈O.05, respectively）. The density of Lactoba- cillus in RVVC group was significantly lower than that in control group （P〈O.05）, while the densities of Gardnerella vaginalis, Gram-positive cocci and other species were significantly higher respectively than those in control group （P〈O. 05）. Species diversity of women with RVVC significantly exceeded that of control group （P〈O.05）. More than half of vaginal communities in R VVC group lost Lactobacillus-dominating and were predominated by other bacteria such as Gardnerella vaginalis and Gram-positive cocci. The prevalence of Gardnerella vaginalis-dominating and Gram-positive cocci-domi- nating communities in RVVC group （37.55% and 19.83%） were significantly higher than those in control group （1.30% and 1.73%） （P〈0.05）. Conclusion The significant changes in vaginal bacterial community were observed in RVVC women. Such variations in community might relate to vaginal biological barrier compromising and increase the risk to the recurrence of VVC. It is still controversial whether probiotics can prevent recurrences of VVC, and more randomized, doubleblind, placebo-controlled trials with a larger sample size should be carried out, so as to clarify its effects for the prophylaxis of RVVC.
基金supported by the Scientific Research Programme of the Gaziantep University of Turkey.
文摘Inflammation of the vagina and vulva caused by Candida is called vulvovaginal candidiasis(VVC).Risk factors for VVC include pregnancy,diabetes mellitus,frequent oral sexual intercourse,and the use of tight synthetic underwear and systemic antibiotics.Candida albicans,which belongs to the normal flora of the vagina,is the most common cause of VVC.However,an increase in VVC episodes caused by non-albicans Candida species,including Candida glabrata,Candida tropicalis,Candida krusei and Candida parapsilosis,has been reported.In this study,a total of 100 Candida isolates obtained from patients with vaginitis symptoms were evaluated.The susceptibility of the Candida strains to amphotericin B,itraconazole,fluconazole,ketoconazole,voriconazole and caspofungin was investigated using the reference broth microdilution method.Risk factors and demographic characteristics of the patients and the identified Candida species were also investigated.Among the 100 Candida strains isolated from vaginal samples,47(47%)were C.albicans,43(43%)C.glabrata,5(5%)C.kefyr,2(2%)C.krusei,2(2%)C.tropicalis and 1(1%)was Candida guilliermondii.The incidences of Candida susceptibility to caspofungin,fluconazole,itraconazole,voriconazole,ketoconazole and amphotericin B were 75%,35%,27%,80%,97%and 100%,respectively.Also,there was a significant difference in antifungal susceptibility among patients belonging to certain risk groups,such as patients previously using antibiotics and recurrent cases.Prevalence of non-albicans Candida species and antifungal resistance,especially against azoles,are both increasing,and certain risk factors should be monitored strictly.
文摘OBJECTIVE:To summarize and evaluate the effectiveness and safety of Redcore lotion on treating vulvovaginal candidiasis(VVC)using a systematic review and Meta-analysis of randomized controlled trials.METHODS:A systematic literature search was performed in five English and three Chinese electronic databases up to October 2019.Randomized controlled trials in the treatment for VVC were included;only studies which compared the effectiveness and safety of Redcore lotion plus miconazole with miconazole alone were included.Relative risk(RR)and 95%confidence intervals(CI)were used in the Meta-analysis.RESULTS:Seven studies involving 768 patients suffering from VVC were identified;468 of the patients were pregnant women(60.9%).Combination group(Redcore lotion plus miconazole)was more effective in redu CIng symptomatic episodes of VVC than miconazole alone,with respect to cure rate(RR,1.31;95%CI,1.09-1.57;P=0.01),fungal culture negative rate(RR,1.21;95%CI,1.04-1.41;P=0.01),and effective rate(RR,1.18;95%CI,1.05-1.35;P=0.01).Subgroup analyses for pregnant women also showed that the combination group had superior outcomes with respect to VVC cure rate(RR,1.48;95%CI,1.16-1.88,P<0.01),fungal culture negative rate(RR,1.26;95%CI;1.09-1.47;P<0.01),and effective rate(RR,1.25;95%CI,1.10-1.42;P<0.01).Additionally,the observed risk of adverse events was lower in the combination medication group(RR,0.30;95%CI,0.14-0.65;P<0.01).CONCLUSIONS:Though overall quality of individual studies was low,Redcore lotion plus miconazole can significantly improve clinical effectiveness and safety compared with miconazole alone.
基金Reproductive and Nutritional Metabolism Innovation Team(303/132041934)。
文摘Summarizing two cases of vaginal candidiasis,cured by integrated traditional Chinese and western medicine in clinical work,it is found that the combination of traditional Chinese and western medicine has a significant effect on the treatment of this disease.The curative effect is outstanding,and the recurrence rate is significantly reduced,which can be used as a reference for gynecological medical workers.
文摘In order to analyze the in vivo expression of Candida albicans secreted aspartyl pro- teinases (SAP) in human vaginal infection, the vaginal secretion from 29 human subjects was col- lected by vaginal swab, and the expression of SAP1–SAP6 was detected by reverse-transcriptase po- lymerase chain reaction using specific primer sets. It was found that Sap2 and Sap5 were the most common genes expressed during infection; Sap3 and Sap4 were detected in all subjects and all 6 SAP genes were simultaneously expressed in some patients with vaginal candidiasis. It was suggested that the SAP family is expressed by Candida albicans during infection in human and that Candida albi- cans infection is associated with the differential expression of individual SAP genes which may be involved in the pathogenesis of vaginal candidiasis.
文摘<b style="line-height:1.5;"><span style="font-family:Verdana;">Background:</span></b><span "="" style="line-height:1.5;"><span style="font-family:Verdana;"> Vaginitis refers to any inflammation or infection of the vagina. This is a common gynecological problem found in women of all ages, with one-third of women having at least one form of vaginitis at some time during their lives. The vagina is the muscular passageway between the uterus and the external genital area. When the walls of the vagina become inflamed, because some irritant has disturbed the balance of the vaginal area, vaginitis can occur. The most common types of vaginitis are: Candida or “yeast” infection, Bacterial vaginosis, Trichomoniasis vaginitis. </span><b><span style="font-family:Verdana;">Objectives of Study:</span></b><span style="font-family:Verdana;"> Therefore, the present study was carried out to determine the prevalence of bacterial vaginosis (BV), vulvovaginal candidiasis (VVC) among married and unmarried women and evaluat</span></span><span style="line-height:1.5;font-family:Verdana;">e</span><span "="" style="line-height:1.5;"><span style="font-family:Verdana;"> the association socio-demographic risk factors and symptoms-related variables in women attending gynecology clinic in Hargeisa group hospital. </span><b><span style="font-family:Verdana;">Methodology:</span></b><span style="font-family:Verdana;"> A total of 150 married and unmarried women w</span></span><span style="line-height:1.5;font-family:Verdana;">ere</span><span style="line-height:1.5;font-family:Verdana;"> investigated & diagnosed by a researcher in Hargeisa Group Hospital, Hargeisa City, Somaliland for determin</span><span style="line-height:1.5;font-family:Verdana;">ing</span><span "="" style="line-height:1.5;"><span style="font-family:Verdana;"> of VVI prevalence in the present study. Vaginal swabs from these patients were processed for detection of bacterial vaginosis (BV), VVC and trichomoniasis based on guidelines of management of vagina infection. Species specific distribution of VVC was assessed by cultured of </span><i><span style="font-family:Verdana;">Candida</span></i><span style="font-family:Verdana;"> on differential agar media, Germ tube test, rice meal agar and carbohydrates fermentation test and BV diagnosed by us</span></span><span style="line-height:1.5;font-family:Verdana;">ing</span><span "="" style="line-height:1.5;"><span style="font-family:Verdana;"> gram staining test and biochemical testes. The nurse interviewers performed a comprehensive review of patients and completed the standardized baseline questionnaire containing information regarding the association socio-demographic risk factors and symptoms-related. </span><b><span style="font-family:Verdana;">Results & Discussion: </span></b><span style="font-family:Verdana;">The findings of the present study indicate that VVC was the most prevalent infection with 68 (45%) followed by BV 43 (29%). However, no case of trichomoniasis was detected. </span><i><span style="font-family:Verdana;">Candida albicans</span></i><span style="font-family:Verdana;"> was found to be the most prevalent species with 47</span></span><span "="" style="line-height:1.5;"> </span><span "="" style="line-height:1.5;"><span style="font-family:Verdana;">(60.3%). Out of non-albicans </span><i><span style="font-family:Verdana;">Candida</span></i><span style="font-family:Verdana;"> (NAC) species, </span><i><span style="font-family:Verdana;">C.</span></i></span><i style="line-height:1.5;"><span "=""> </span></i><i style="line-height:1.5;"><span style="font-family:Verdana;">tropicali</span></i><i style="line-height:1.5;"><span style="font-family:Verdana;">s</span></i><span "="" style="line-height:1.5;"><span style="font-family:Verdana;"> was found to be 9 (9.9%) and </span><i><span style="font-family:Verdana;">C.</span></i></span><i style="line-height:1.5;"><span "=""> </span></i><i style="line-height:1.5;"><span style="font-family:Verdana;">glabrata </span></i><span style="line-height:1.5;font-family:Verdana;">7</span><span "="" style="line-height:1.5;"> </span><span "="" style="line-height:1.5;"><span style="font-family:Verdana;">(12.2%). On the other hand, the results of present study indicated that BV species </span><i><span style="font-family:Verdana;">Gardnerella vaginalis</span></i><span style="font-family:Verdana;"> was most causative with</span><i> </i><span style="font-family:Verdana;">22</span></span><span "="" style="line-height:1.5;"> </span><span "="" style="line-height:1.5;"><span style="font-family:Verdana;">(19</span><i><span style="font-family:Verdana;">.</span></i><span style="font-family:Verdana;">5) and</span></span><span "="" style="line-height:1.5;"> <i><span style="font-family:Verdana;">Lactobacillus spp</span></i><span style="font-family:Verdana;">. was 14</span></span><span "="" style="line-height:1.5;"> </span><span style="line-height:1.5;font-family:Verdana;">(9.3%)</span><span style="line-height:1.5;font-family:Verdana;">.</span><i style="line-height:1.5;"><span "=""> </span></i><span style="line-height:1.5;font-family:Verdana;">These results were also confirmed by gram staining test and biochemical testes. When VVI w</span><span style="line-height:1.5;font-family:Verdana;">as</span><span style="line-height:1.5;font-family:Verdana;"> compared among married and unmarried women, VVC was more prevalent in married women 47</span><span "="" style="line-height:1.5;"> </span><span style="line-height:1.5;font-family:Verdana;">(31.96) while, BV w</span><span style="line-height:1.5;font-family:Verdana;">as</span><span style="line-height:1.5;font-family:Verdana;"> more prevalent in unmarried women with 32</span><span "="" style="line-height:1.5;"> </span><span style="line-height:1.5;font-family:Verdana;">(13.76)</span><span style="line-height:1.5;font-family:Verdana;">,</span><span style="line-height:1.5;font-family:Verdana;"> discussed these results detected that prevalent found most highly with VVB and BV while, no case of trichomoniasis was detected. These findings are in consonance with various previous studies which have indicated VVC & BV to be the most prevalent in VI. Furthermore, the study showed statistical significant difference (P</span><span "="" style="line-height:1.5;"> </span><span style="line-height:1.5;font-family:Verdana;"><</span><span "="" style="line-height:1.5;"> </span><span style="line-height:1.5;font-family:Verdana;">0.005) & relationship among prevalence of VVV & BV and some socio-demo</span><span "="" style="line-height:1.5;"><span style="font-family:Verdana;">graphic risk factors and some symptoms which have been identified as causes of variation in the prevalence rates of bacterial vaginosis & vagina candidasis. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> VVC was the most prevalent VVI followed by BV in Hargeisa City. </span><i><span style="font-family:Verdana;">C. albicans</span></i><span style="font-family:Verdana;"> was the most prevalent species in VVC while among BV species, </span><i><span style="font-family:Verdana;">Gardnerella vaginalis was </span></i><span style="font-family:Verdana;">found to occur at highest frequency. However, further studies are needed to assess specific diagnosis and role of clinical risk factors. Urgent action is required to improve vagina infection control measures to reduce the prevalence and make new policies for treatment of vagina infection in HGH.
文摘Purpose: To evaluate the profile of in vitro susceptibility of yeasts isolated from cases of primary and espisodic vulvovaginitis to two antifungal agents. Methods: 40 Candida isolates from episodes of vulvovaginal candidiasis were identified by classic methodologies. The susceptibility testing of the in vitro fluconazole and ketoconazole activity against the isolates was accessed by E-test. Results: C. albicans was the most common species identified in 70% of the occurrences followed by C. glabrata (20%), C. tropicalis (7.5%), and C. guilliermondii (2.5%). In the susceptibility profile to antifungal agents, 12.5% and 16.7% of the isolates obtained from primary and episodic vulvovaginal candidiasis were resistant to fluconazole, respectively. To ketoconazole, we found that 6.25% and 12.5% of the isolates respectively from primary vulvovaginal candidiasis (PVVC) and episodic vulvovaginal candidiasis (EVVC) had high MIC values. Conclusions: E-test is a reliable method for the susceptibility testing of Candida spp. due to its simplicity, reproducibility, and lack of specialized equipment. Resistant strains and non-albicans species were verified more in cases of EVVC than in PVVC. Clinical and mycological cure of patients with episodic vulvovaginal candidiasis or complicated cases occurred after prolonged treatment and sometimes with multiple antifungals use.
基金Acknowledgements The authors are thankful to all the clinicians and microbiologists for referring vulvovaginal yeast isolates to the mycology reference laboratory. Excellent technical support received from Min Zhao is acknowledged.Financial support and sponsorship This study was supported by a grant from the National Natural Science Foundation of China （No. 81571394）.
文摘Background： Vulvovaginal candidiasis （WC） was a common infection associated with lifelong harassment of woman＇s social and sexual life. The purpose of this study was to describe the species distribution and in vitro antifungal susceptibility of Candida species （Candida spp.） isolated from patients with VVC over 8 years. Methods： Species which isolated from patients with VVC in Peking University First Hospital were identified using chromogenic culture media. Susceptibility to common antifungal agents was determined using agar diffusion method based on CLSI M44-A2 document. SPSS software （version 14.0, Inc., Chicago, IL, USA） was used for statistical analysis, involving statistical description and Chi-square test. Results： The most common strains were Candida （C.） albicans, 80.5% （n = 1775） followed by C. glabrata, 18.1% （n = 400）. Nystatin exhibited excellent activity against all species （〈4% resistant JR]）. Resistance to azole drugs varied among different species. C. albicans： clotrimazole （3.1% R） 〈 fluconazole （ 16.6% R） 〈 itraconazole （51.5% R） 〈 mieonazole （54.0% R）, C. glabrata： miconazole （25.6% R） 〈 clotrimazole （50.5% R） 〈 itraconazole （61.9% R） 〈 fluconazole （73.3% R）; Candida krusei： clotrimazole （0 R） 〈 fluconazole （57.7% R） 〈 miconazole （73.1% R） 〈 itraconazole （83.3% R）. The susceptibility of fluconazole was noticeably decreasing among all species in the study period. Conclusions： Nystatin was the optimal choice for the treatment of VVC at present. The species distribution and in ~＇itro antifungal susceptibility of Candida spp. isolated from patients with VVC had changed over time.
基金supported by The 19th Minsheng Science and Technology Project of Suzhou SS201702,Soochow.
文摘Objective: The effect of alterations in vaginal flora during pregnancy remains uncertain. We compared the flora distribution in women with spontaneous abortion(SA) and those in normal condition.Methods: Samples of vaginal discharge were obtained from 3,233 women attending the Gynecological and Public Health Centre of our hospital from January 2010 to December 2013. Pathogen culture testing was performed by the Microbiological Diagnostic Centre of our hospital, including SA group(n= 1,513), normal first-trimester group(NP group, n = 908), and nonpregnant women(control group, n= 812).Results: Of 3,233 vaginal discharge samples, 425 samples(13.15%) were positive for pathogen. The pathogen detection rate was19.96%(302/1,513), 7.93%(72/908), and 6.28%(51/812) in the SA, NP, and control groups, respectively. The five most common bacteria were Enterococcus faecalis, Candida albicans, Escherichia coli, group B Streptococcus(GBS), and Ureaplasma urealyticum(Uu) in the SA group; Uu, C. albicans, Candida tropicalis, GBS, and E.faecalis in the NP group; and Candida glabrata, Uu, E. coli, Gardnerella vaginalis,and C. albicans in the control group.Conclusions: In the SA group, the pathogen detection rate was markedly elevated. An infection of Candida sp. in pregnant women was relatively common. In routine antenatal care, overtreatment is not recommended in asymptomatic candidiasis. There was no significant difference in the detection rate of Uu between the SA group and the other two groups, suggesting that it does not cause SA.
